Provider Demographics
NPI:1811579378
Name:STIJEPOVIC, DRAGANA (LCSW)
Entity Type:Individual
Prefix:
First Name:DRAGANA
Middle Name:
Last Name:STIJEPOVIC
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 1:8179 CALIFORNIA AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-2471
Mailing Address - Country:US
Mailing Address - Phone:562-445-1544
Mailing Address - Fax:
Practice Address - Street 1:8179 CALIFORNIA AVE APT 1
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-2471
Practice Address - Country:US
Practice Address - Phone:562-445-1544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1010661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical