Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 21999 | CA |
NPI | 1003091331 |
---|---|
Provider Name | Ms. Heidi M Weinreich |
First Address | Los Angeles, CA 90027-2141 |
Second Address | Los Angeles, CA 90027-2141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2008 |
Last Update Date | 06/01/2008 |