MEDICARE: JAN L LIPSCHUTZ MSW

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	LCS4171	CA

General Provider Information

NPI Number	:	1972594000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAN L LIPSCHUTZ MSW

Provider Business Mailing Address
First Line	:	2001 S BARRINGTON AVE
Second Line	:	#307
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5363
Country	:	US
Telephone Number	:	310-390-5585
Fax Number	:	310-390-9896

Provider Business Practice Location Address
First Line	:	2001 S BARRINGTON AVE
Second Line	:	#307
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5363
Country	:	US
Telephone Number	:	310-390-5585
Fax Number	:	310-390-9896

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

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	07/08/2007

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