Provider Demographics
NPI:1346448610
Name:DEMUS, NATALIE DIANE (LCSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:DIANE
Last Name:DEMUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E UNIVERSITY DR # B188
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1969
Mailing Address - Country:US
Mailing Address - Phone:310-645-1081
Mailing Address - Fax:
Practice Address - Street 1:603 E UNIVERSITY DR # B188
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-1969
Practice Address - Country:US
Practice Address - Phone:310-645-1081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS173511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical