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NPI Code Detail

MEDICARE: LAURA POLICARPO HERNANDEZ MSW, ACSW

MEDICARE: LAURA POLICARPO HERNANDEZ MSW, ACSW
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 WorkerASW123722CA

General Provider Information

NPI Number : 1730817743
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA POLICARPO HERNANDEZ MSW, ACSW
Provider Business Mailing Address
First Line : 3435 WILSHIRE BLVD STE 1840
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-2004
Country : US
Telephone Number : 323-578-9668
Fax Number :
Provider Business Practice Location Address
First Line : 3435 WILSHIRE BLVD STE 1840
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-2004
Country : US
Telephone Number : 323-578-9668
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2022
Last Update Date : 08/08/2024

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