Provider Demographics
NPI:1629263983
Name:INFANTE, JUANA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUANA
Middle Name:M
Last Name:INFANTE
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 1:330 E LIVE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5617
Mailing Address - Country:US
Mailing Address - Phone:626-821-5858
Mailing Address - Fax:626-447-4792
Practice Address - Street 1:330 E LIVE OAK AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5617
Practice Address - Country:US
Practice Address - Phone:626-821-5858
Practice Address - Fax:626-447-4792
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW601021041C0700X
CAASW 142981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA533252OtherLA COUNTY DMH
CACB75403OtherLA COUNTY DMH PROVIDER #