MEDICARE: JENNIFER R MAUCERI LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	077449	NY
2	1041C0700X	Clinical Social Worker	71179	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538484670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER R MAUCERI LCSW

Provider Business Mailing Address
First Line	:	6200 CANOGA AVE STE 210
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-7794
Country	:	US
Telephone Number	:	646-694-2434
Fax Number	:	818-350-2988

Provider Business Practice Location Address
First Line	:	6200 CANOGA AVE STE 210
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-7794
Country	:	US
Telephone Number	:	646-694-2434
Fax Number	:	818-350-2988

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2010
Last Update Date	:	04/24/2024

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Directions to “ JENNIFER R MAUCERI LCSW” Practice Location

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