Provider Demographics
NPI:1891449492
Name:HOSSAIN, MOSAMMAT NUSHRAH (MSW, ACSW)
Entity Type:Individual
Prefix:
First Name:MOSAMMAT
Middle Name:NUSHRAH
Last Name:HOSSAIN
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12036 GOSHEN AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6342
Mailing Address - Country:US
Mailing Address - Phone:505-463-3961
Mailing Address - Fax:
Practice Address - Street 1:690 E GREEN ST STE 202
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2197
Practice Address - Country:US
Practice Address - Phone:505-463-3961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical