Doctor Name: | WENDY NAN BLOCK |
NPI Number: | 1033312822 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S,W. |
License Number: | LCS14643 |
Business Practice Address: | 4132 Katella Ave Suite 206 Los Alamitos, CA - 907203426 |
Business Phone Number: | 5623105505 |
Business Fax Number: | 5627990747 |
Mailing Address: | 3032 Kempton Dr, LOS ALAMITOS |
State: | CA |
Postal Code: | 907204622 |
Phone Number: | 5627990747 |
Fax Number: | 5627990747 |
NPI Enumeration Date: | 06/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS14643 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |