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NPI Code Detail

MEDICARE: MS. KIMBERLY DIANNE MCELREATH LCSW

MEDICARE: MS. KIMBERLY DIANNE MCELREATH 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
11041C0700XClinical Social WorkerLCS21656CA

General Provider Information

NPI Number : 1821128323
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY DIANNE MCELREATH LCSW
Provider Business Mailing Address
First Line : 11601 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-5006
Country : US
Telephone Number : 323-242-5000
Fax Number :
Provider Business Practice Location Address
First Line : 11601 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-5006
Country : US
Telephone Number : 323-242-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 04/10/2025

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