MEDICARE: MS. JEAN F OLIVER MSW 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	LCS2683	CA

General Provider Information

NPI Number	:	1588792626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEAN F OLIVER MSW LCSW

Provider Business Mailing Address
First Line	:	3870 S CRENSHAW BLVD
Second Line	:	SUITE 216
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-1815
Country	:	US
Telephone Number	:	323-295-5359
Fax Number	:	323-292-9492

Provider Business Practice Location Address
First Line	:	3870 S CRENSHAW BLVD
Second Line	:	SUITE 216
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-1815
Country	:	US
Telephone Number	:	323-295-5359
Fax Number	:	323-292-9492

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	05/12/2013

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