Keven Fitzgerald Ulrich, is a
Social Worker - Clinical based in Lynwood, California. Keven Fitzgerald Ulrich is licensed to practice in California (license number ASW115294) and his current practice location is
2640 Industry Way, Lynwood, California. He can be reached at his office (for appointments etc.) via phone at
(310) 627-4525.
NPI number for Keven Fitzgerald Ulrich is 1619682655 and his current mailing address is 2640 Industry Way, Lynwood, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619682655.
Healthcare Provider's Profile
| Full Name | Keven Fitzgerald Ulrich |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 2640 Industry Way, Lynwood, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1619682655
- Provider Enumeration Date: 01/13/2023
- Last Update Date: 08/16/2023
Medical Identifiers
Medical identifiers for Keven Fitzgerald Ulrich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619682655 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | ASW115294 (California) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | ASW115294 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keven Fitzgerald Ulrich is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Keven Fitzgerald Ulrich,
2640 Industry Way,
Lynwood, CA 90262-4284
Ph: () - | Keven Fitzgerald Ulrich,
2640 Industry Way,
Lynwood, CA 90262-4284
Ph: (310) 627-4525 |
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