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PHAEDRA ALLEN
>> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1063873305
Individual Registrant: PHAEDRA ALLEN
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
5650 JILLSON ST COMMERCE, CA 90040-1482 US
Tel: 323-201-4516 Fax: --
Tel: 323-201-4516 Fax: --
Contact information for business:
5650 JILLSON ST COMMERCE, CA 90040-1482 US
Tel: 323-201-4516 Fax: --
Tel: 323-201-4516 Fax: --
Registration Information:
NPI: 1063873305
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 104100000X | Behavioral Health & Social Service Providers Social Worker | CA | ASW69311 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
