Provider Demographics
NPI:1629295639
Name:BLUM, NAOMI (LCSW, DCSW)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:
Last Name:BLUM
Suffix:
Gender:F
Credentials:LCSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W. 5TH STREET #310
Mailing Address - Street 2:#310
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90071
Mailing Address - Country:US
Mailing Address - Phone:310-395-8254
Mailing Address - Fax:310-395-8254
Practice Address - Street 1:601 W. 5TH ST.
Practice Address - Street 2:#310
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071
Practice Address - Country:US
Practice Address - Phone:310-395-8254
Practice Address - Fax:310-395-8254
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS138151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical