Provider Demographics
NPI:1245385533
Name:TIMM, SIGNE ANNE (MSW)
Entity Type:Individual
Prefix:
First Name:SIGNE
Middle Name:ANNE
Last Name:TIMM
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 1:332 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-2738
Mailing Address - Country:US
Mailing Address - Phone:562-439-8661
Mailing Address - Fax:
Practice Address - Street 1:25500 HAWTHORNE BLVD
Practice Address - Street 2:SUITE# 1240
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6829
Practice Address - Country:US
Practice Address - Phone:310-378-0379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS105921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical