Provider Demographics
NPI:1629099882
Name:KATIBIAN, NELDA BLISS (MSW)
Entity Type:Individual
Prefix:MRS
First Name:NELDA
Middle Name:BLISS
Last Name:KATIBIAN
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 1:27852 PERALES
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-2526
Mailing Address - Country:US
Mailing Address - Phone:949-768-5171
Mailing Address - Fax:949-458-9800
Practice Address - Street 1:3491 ELM AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4430
Practice Address - Country:US
Practice Address - Phone:562-427-4864
Practice Address - Fax:562-427-4968
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health