Provider Demographics
NPI:1093572398
Name:YAEL EISERIKE, A LICENSED CLINICAL SOCIAL WORKER PC
Entity Type:Organization
Organization Name:YAEL EISERIKE, A LICENSED CLINICAL SOCIAL WORKER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EISERIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-359-0320
Mailing Address - Street 1:3500 W OLIVE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3500 W OLIVE AVE STE 300
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4647
Practice Address - Country:US
Practice Address - Phone:310-359-0320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty