Provider Demographics
NPI:1376162958
Name:WHITFIELD, EILEEN GRACE (LCSW)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:GRACE
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:GRACE
Other - Last Name:DEGUZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACSW
Mailing Address - Street 1:3330 LOMITA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5002
Mailing Address - Country:US
Mailing Address - Phone:310-891-6634
Mailing Address - Fax:
Practice Address - Street 1:3330 LOMITA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5002
Practice Address - Country:US
Practice Address - Phone:310-891-6634
Practice Address - Fax:310-784-4822
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS287931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical