Provider Demographics
NPI:1114454253
Name:NAILES, AMBER (MSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:NAILES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 W 127TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-5334
Mailing Address - Country:US
Mailing Address - Phone:1323-490-3250
Mailing Address - Fax:
Practice Address - Street 1:520 S GRAND AVE STE 680
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071-2655
Practice Address - Country:US
Practice Address - Phone:323-924-9084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool