Provider Demographics
NPI:1023210077
Name:O'MARA, ANNE S (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:S
Last Name:O'MARA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:O'MARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1033 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5950
Mailing Address - Country:US
Mailing Address - Phone:310-379-8100
Mailing Address - Fax:310-379-8393
Practice Address - Street 1:9400 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2246
Practice Address - Country:US
Practice Address - Phone:562-461-6525
Practice Address - Fax:562-461-4910
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS16311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical