MEDICARE: MRS. SUSAN GRINBERG-SMITH 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	LCSW23827	CA

General Provider Information

NPI Number	:	1801825146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN GRINBERG-SMITH LCSW

Provider Business Mailing Address
First Line	:	11278 LOS ALAMITOS BLVD # 226
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3958
Country	:	US
Telephone Number	:	818-309-5966
Fax Number	:

Provider Business Practice Location Address
First Line	:	11278 LOS ALAMITOS BLVD # 226
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3958
Country	:	US
Telephone Number	:	818-309-5966
Fax Number	:

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	06/05/2025

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