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NPI Code Detail

MEDICARE: MR. RODOLFO LOERA LCSW

MEDICARE: MR. RODOLFO LOERA 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
11041C0700XClinical Social WorkerLCSW88144CA

General Provider Information

NPI Number : 1699103085
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RODOLFO LOERA LCSW
Provider Business Mailing Address
First Line : 1801 S POPLAR ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-4321
Country : US
Telephone Number : 714-376-9781
Fax Number :
Provider Business Practice Location Address
First Line : 1801 S POPLAR ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-4321
Country : US
Telephone Number : 714-376-9781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2013
Last Update Date : 05/17/2023

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