Provider Demographics
NPI:1851596456
Name:BROWN, JERI - (MSW)
Entity Type:Individual
Prefix:MS
First Name:JERI
Middle Name:-
Last Name:BROWN
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 1:5657 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3736
Mailing Address - Country:US
Mailing Address - Phone:323-876-0400
Mailing Address - Fax:
Practice Address - Street 1:5657 WILSHIRE BLVD
Practice Address - Street 2:SUITE 340
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3736
Practice Address - Country:US
Practice Address - Phone:323-876-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASW179971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical