MEDICARE: EWA CHROSTEK

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	LCSW93124	CA

General Provider Information

NPI Number	:	1679914774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EWA CHROSTEK

Provider Business Mailing Address
First Line	:	251 E AVENUE K6
Second Line	:	N/A
City	:	LANCASTER
State	:	CA
Zip	:	93535-4513
Country	:	US
Telephone Number	:	661-974-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 E AVENUE K6
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93535-4513
Country	:	US
Telephone Number	:	661-974-8400
Fax Number	:

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

Provider Enumeration Date	:	07/17/2013
Last Update Date	:	03/18/2021

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Directions to “ EWA CHROSTEK ” Practice Location

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