Provider Demographics
NPI:1649768201
Name:LOBBEN, INGRID (MSW)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:LOBBEN
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 1:13810 NW PASSAGE APT 106
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-7469
Mailing Address - Country:US
Mailing Address - Phone:917-331-2888
Mailing Address - Fax:
Practice Address - Street 1:13810 NW PASSAGE APT 106
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-7469
Practice Address - Country:US
Practice Address - Phone:917-331-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-28
Last Update Date:2018-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW724161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical