Provider Demographics
NPI:1215583950
Name:MATHIEU, AMBER ANN (LCSW, PPSC)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:ANN
Last Name:MATHIEU
Suffix:
Gender:F
Credentials:LCSW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14029 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-3110
Mailing Address - Country:US
Mailing Address - Phone:626-862-9351
Mailing Address - Fax:
Practice Address - Street 1:14029 CLARK ST
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3110
Practice Address - Country:US
Practice Address - Phone:626-862-9351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1143291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical