| Dr. Jordana Mansbacher, Lcnd Clin Scl Worker A Professional Corp | |
|
5519 S Centinela Ave Suite 105 Los Angeles CA 90066-6945 | |
| (310) 301-9121 | |
| (310) 390-8578 |
| Full Name | Dr. Jordana Mansbacher, Lcnd Clin Scl Worker A Professional Corp |
|---|---|
| Speciality | Social Worker |
| Location | 5519 S Centinela Ave, Los Angeles, California |
| Authorized Official Name and Position | Jordana Mansbacher (OWNER/PRACTITIONER) |
| Authorized Official Contact | 3103019121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Jordana Mansbacher, Lcnd Clin Scl Worker A Professional Corp 5519 S Centinela Ave Suite 105 Los Angeles CA 90066-6945 Ph: (310) 301-9121 | Dr. Jordana Mansbacher, Lcnd Clin Scl Worker A Professional Corp 5519 S Centinela Ave Suite 105 Los Angeles CA 90066-6945 Ph: (310) 301-9121 |
| NPI Number | 1831447663 |
|---|---|
| Provider Enumeration Date | 08/28/2012 |
| Last Update Date | 10/01/2012 |
| Medicare PECOS PAC ID | 5890945323 |
|---|---|
| Medicare Enrollment ID | O20121018000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831447663 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCS21516 (California) | Primary |
| Provider Name | Jordana Mansbacher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316963937 PECOS PAC ID: 0749276780 Enrollment ID: I20040423000750 |
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