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NPI Code Detail

MEDICARE: CEDRIA ROBERSON

MEDICARE: CEDRIA ROBERSON
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 Worker

General Provider Information

NPI Number : 1740429349
Entity Type Code : Individual
Provider Name (Legal Business Name) : CEDRIA ROBERSON
Provider Business Mailing Address
First Line : 11705 DEPUTY YAMAMOTO PL
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-4031
Country : US
Telephone Number : 323-357-6930
Fax Number :
Provider Business Practice Location Address
First Line : 11705 DEPUTY YAMAMOTO PL
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-4031
Country : US
Telephone Number : 323-357-6930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2009
Last Update Date : 02/05/2009

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Directions to “ CEDRIA ROBERSON ” Practice Location

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