Provider Demographics
NPI:1003217829
Name:RATZERSDORFER, NAAMA
Entity Type:Individual
Prefix:
First Name:NAAMA
Middle Name:
Last Name:RATZERSDORFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 NATIONAL BLVD STE 256
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4178
Mailing Address - Country:US
Mailing Address - Phone:424-261-6887
Mailing Address - Fax:
Practice Address - Street 1:10801 NATIONAL BLVD STE 256
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-4178
Practice Address - Country:US
Practice Address - Phone:424-261-6887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW62352101YM0800X
CALCSW77198104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health