| Doctor Name: | KENNETH R PRESCOTT |
| NPI Number: | 1154617231 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, LCSW |
| License Number: | 16705 |
| Business Practice Address: | 20151 Nordhoff St Chatsworth, CA - 913116215 |
| Business Phone Number: | 8187174694 |
| Business Fax Number: | |
| Mailing Address: | 13206 Lake St, LOS ANGELES |
| State: | CA |
| Postal Code: | 900662207 |
| Phone Number: | 3103984916 |
| Fax Number: | |
| NPI Enumeration Date: | 06/27/2011 |
| NPI Last Update Date: | 06/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 16705 |
| 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 |