Provider Demographics
NPI:1164540449
Name:CERVANTES, DENISE A (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:A
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 S BIXEL ST STE 150
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1418
Mailing Address - Country:US
Mailing Address - Phone:213-749-4261
Mailing Address - Fax:213-745-1040
Practice Address - Street 1:350 S BIXEL ST STE 150
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1418
Practice Address - Country:US
Practice Address - Phone:213-749-4261
Practice Address - Fax:213-745-1040
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA1101361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker