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NPI Code Detail

MEDICARE: MS. KATHERINE ANN SPINA LCSW

MEDICARE: MS. KATHERINE ANN SPINA 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
1104100000XSocial WorkerLCSW77975CA

General Provider Information

NPI Number : 1760639876
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHERINE ANN SPINA LCSW
Provider Business Mailing Address
First Line : 4169 VIA MARINA APT 310
Second Line :
City : MARINA DEL REY
State : CA
Zip : 90292-5330
Country : US
Telephone Number : 970-708-7299
Fax Number :
Provider Business Practice Location Address
First Line : 3384 MOTOR AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3712
Country : US
Telephone Number : 970-708-7299
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2008
Last Update Date : 10/19/2017

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Directions to “ MS. KATHERINE ANN SPINA LCSW” Practice Location

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