MEDICARE: MRS. JUDITH ANN CASWICK 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	LCS 21563	CA

General Provider Information

NPI Number	:	1861538555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUDITH ANN CASWICK LCSW

Provider Business Mailing Address
First Line	:	22703 FONTHILL AVE
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90505-2832
Country	:	US
Telephone Number	:	310-530-0881
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 AVENUE I
Second Line	:	SUITE 19
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5619
Country	:	US
Telephone Number	:	310-710-1530
Fax Number	:

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/08/2007

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