MEDICARE: MS. JENNIFER NICOLE LOMAS LCSW, DSW, PPSC

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	LCSW25211	CA

General Provider Information

NPI Number	:	1942324983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER NICOLE LOMAS LCSW, DSW, PPSC

Provider Business Mailing Address
First Line	:	115 W CALIFORNIA BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3005
Country	:	US
Telephone Number	:	626-497-3061
Fax Number	:

Provider Business Practice Location Address
First Line	:	3680 E IMPERIAL HWY STE 220
Second Line	:
City	:	LYNWOOD
State	:	CA
Zip	:	90262-2663
Country	:	US
Telephone Number	:	323-796-7174
Fax Number	:

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

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	09/01/2021

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