Provider Demographics
NPI:1073061255
Name:AHLZADEH, FLORENCE (LCSW)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:
Last Name:AHLZADEH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8837 1/2 ALCOTT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-5606
Mailing Address - Country:US
Mailing Address - Phone:818-640-2050
Mailing Address - Fax:
Practice Address - Street 1:8837 1/2 ALCOTT ST APT 1
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-5606
Practice Address - Country:US
Practice Address - Phone:818-640-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA719631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical