| Lv Patterson Llc | |
|
512 Redondo Ave # C-1 Long Beach CA 90814-1552 | |
| (213) 675-9016 | |
| Not Available |
| Full Name | Lv Patterson Llc |
|---|---|
| Speciality | Social Worker |
| Location | 512 Redondo Ave # C-1, Long Beach, California |
| Authorized Official Name and Position | Lenwood Patterson (OWNER) |
| Authorized Official Contact | 2136759016 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lv Patterson Llc 1900 E Ocean Blvd Apt 1406 Long Beach CA 90802-6139 Ph: (213) 675-9016 | Lv Patterson Llc 512 Redondo Ave # C-1 Long Beach CA 90814-1552 Ph: (213) 675-9016 |
| NPI Number | 1396495941 |
|---|---|
| Provider Enumeration Date | 03/26/2022 |
| Last Update Date | 06/11/2024 |
| Certification Date | 06/11/2024 |
| Medicare PECOS PAC ID | 3274917109 |
|---|---|
| Medicare Enrollment ID | O20220826000822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396495941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lenwood Patterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831387067 PECOS PAC ID: 5395035364 Enrollment ID: I20160602002374 |
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