| Dr Priscilla Psy D Licensed Clinical Social Worker Corp | |
|
5710 W Manchester Ave Ste 210 Los Angeles CA 90045-4423 | |
| (213) 059-2027 | |
| Not Available |
| Full Name | Dr Priscilla Psy D Licensed Clinical Social Worker Corp |
|---|---|
| Speciality | Social Worker |
| Location | 5710 W Manchester Ave Ste 210, Los Angeles, California |
| Authorized Official Name and Position | Priscilla Gales (OWNER) |
| Authorized Official Contact | 9512031917 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Priscilla Psy D Licensed Clinical Social Worker Corp 11718 Daleside Ave Hawthorne CA 90250-1923 Ph: () - | Dr Priscilla Psy D Licensed Clinical Social Worker Corp 5710 W Manchester Ave Ste 210 Los Angeles CA 90045-4423 Ph: (213) 059-2027 |
| NPI Number | 1649931163 |
|---|---|
| Provider Enumeration Date | 01/06/2022 |
| Last Update Date | 05/04/2023 |
| Certification Date | 05/04/2023 |
| Medicare PECOS PAC ID | 4486013679 |
|---|---|
| Medicare Enrollment ID | O20230706001826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649931163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Priscilla Margaret Gales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841789922 PECOS PAC ID: 6204295496 Enrollment ID: I20230706001874 |
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