Doctor Name: | MR. STEPHEN O. ABANISE |
NPI Number: | 1043530546 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 111 N La Brea Ave Inglewood, CA - 903011752 |
Business Phone Number: | 3106777808 |
Business Fax Number: | |
Mailing Address: | 4760 Sepulveda Blvd, CULVER CITY |
State: | CA |
Postal Code: | 902304820 |
Phone Number: | 3103906612 |
Fax Number: | |
NPI Enumeration Date: | 06/07/2010 |
NPI Last Update Date: | 06/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |