| Ariel Escobedo, Licensed Clinical Social Worker Inc. | |
|
10320 Jackson Ave South Gate CA 90280-6904 | |
| (818) 554-6272 | |
| Not Available |
| Full Name | Ariel Escobedo, Licensed Clinical Social Worker Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 10320 Jackson Ave, South Gate, California |
| Authorized Official Name and Position | Ariel Escobedo (PRESIDENT) |
| Authorized Official Contact | 8185546272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ariel Escobedo, Licensed Clinical Social Worker Inc. 10320 Jackson Ave South Gate CA 90280-6904 Ph: (818) 554-6272 | Ariel Escobedo, Licensed Clinical Social Worker Inc. 10320 Jackson Ave South Gate CA 90280-6904 Ph: (818) 554-6272 |
| NPI Number | 1659015162 |
|---|---|
| Provider Enumeration Date | 04/21/2022 |
| Last Update Date | 04/21/2022 |
| Certification Date | 04/21/2022 |
| Medicare PECOS PAC ID | 9436546009 |
|---|---|
| Medicare Enrollment ID | O20220428002531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659015162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Ariel Escobedo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922331008 PECOS PAC ID: 9032394069 Enrollment ID: I20110506000124 |
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