MEDICARE: NANCY L WEISS 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	LCS8887	CA

General Provider Information

NPI Number	:	1730544123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY L WEISS LCSW

Provider Business Mailing Address
First Line	:	6215 DEL VALLE DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5305
Country	:	US
Telephone Number	:	323-934-5484
Fax Number	:	323-297-2972

Provider Business Practice Location Address
First Line	:	6215 DEL VALLE DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5305
Country	:	US
Telephone Number	:	323-934-5484
Fax Number	:	323-297-2972

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

Provider Enumeration Date	:	12/29/2015
Last Update Date	:	12/29/2015

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Directions to “ NANCY L WEISS LCSW” Practice Location

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