Theodore Kurt Dietz, ACSW is a
Social Worker - Clinical based in Venice, California. Theodore Kurt Dietz is licensed to practice in * (Not Available) (license number ) and his current practice location is
204 Hampton Dr, Venice, California. He can be reached at his office (for appointments etc.) via phone at
(310) 279-3499.
NPI number for Theodore Kurt Dietz is 1205589652 and his current mailing address is 11080 W Olympic Blvd, Los Angeles, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1205589652.
Healthcare Provider's Profile
| Full Name | Theodore Kurt Dietz |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
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| Location | 204 Hampton Dr, Venice, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1205589652
- Provider Enumeration Date: 01/26/2022
- Last Update Date: 06/23/2023
Medical Identifiers
Medical identifiers for Theodore Kurt Dietz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205589652 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 106405 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | 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. Theodore Kurt Dietz 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 |
|---|
Theodore Kurt Dietz, ACSW
11080 W Olympic Blvd,
Los Angeles, CA 90064-1937
Ph: (213) 503-5289 | Theodore Kurt Dietz, ACSW
204 Hampton Dr,
Venice, CA 90291-8633
Ph: (310) 279-3499 |
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