Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCSW71909 | CA |
NPI | 1003103581 |
---|---|
Provider Name | Steven Frausto |
First Address | Long Beach, CA 90813-3124 |
Second Address | San Pedro, CA 90731-3316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2011 |
Last Update Date | 11/01/2021 |