Provider Demographics
NPI:1043216047
Name:DASTEEL, JOAN C (MSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:C
Last Name:DASTEEL
Suffix:
Gender:F
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 N BOWLING GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-2820
Mailing Address - Country:US
Mailing Address - Phone:310-471-1496
Mailing Address - Fax:310-472-5826
Practice Address - Street 1:424 N BOWLING GREEN WAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-2820
Practice Address - Country:US
Practice Address - Phone:310-471-1496
Practice Address - Fax:310-472-5826
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS21261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical