Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS17924 | CA |
NPI | 1003133968 |
---|---|
Provider Name | Laura Alongi Brinderson |
First Address | Hermosa Beach, CA 90254-2751 |
Second Address | Hermosa Beach, CA 90254-2751 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2010 |
Last Update Date | 30/04/2010 |