Provider Demographics
NPI:1659015162
Name:ARIEL ESCOBEDO, LICENSED CLINICAL SOCIAL WORKER INC.
Entity Type:Organization
Organization Name:ARIEL ESCOBEDO, LICENSED CLINICAL SOCIAL WORKER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCOBEDO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-554-6272
Mailing Address - Street 1:10320 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-6904
Mailing Address - Country:US
Mailing Address - Phone:818-554-6272
Mailing Address - Fax:
Practice Address - Street 1:10320 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-6904
Practice Address - Country:US
Practice Address - Phone:818-554-6272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health