MEDICARE: RAQUEL LINDA PLASENCIA I 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	29538	CA

General Provider Information

NPI Number	:	1982899241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAQUEL LINDA PLASENCIA I LCSW

Provider Business Mailing Address
First Line	:	13428 MAXELLA AVE # 195
Second Line	:
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-5620
Country	:	US
Telephone Number	:	310-435-7527
Fax Number	:

Provider Business Practice Location Address
First Line	:	13323 W WASHINGTON BLVD STE 302
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-5164
Country	:	US
Telephone Number	:	310-435-7527
Fax Number	:

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

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	01/05/2026

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