Provider Demographics
NPI:1942470034
Name:BRACAMONTE, MARIBEL (MSW, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIBEL
Middle Name:
Last Name:BRACAMONTE
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:PO BOX 4176
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90707-4176
Mailing Address - Country:US
Mailing Address - Phone:562-572-8743
Mailing Address - Fax:
Practice Address - Street 1:8319 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-4403
Practice Address - Country:US
Practice Address - Phone:562-634-9774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW29328104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker