Provider Demographics
NPI:1134198971
Name:SPEERT, ZORA EM (LCSW)
Entity type:Individual
Prefix:MS
First Name:ZORA
Middle Name:EM
Last Name:SPEERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ZORA
Other - Middle Name:EM
Other - Last Name:SPEERT-DIETERICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1300 W OLYMPIC BLVD
Mailing Address - Street 2:#800
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064
Mailing Address - Country:US
Mailing Address - Phone:310-476-2566
Mailing Address - Fax:310-312-6680
Practice Address - Street 1:1300 W OLYMPIC BLVD
Practice Address - Street 2:#800
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:310-476-2566
Practice Address - Fax:310-312-6680
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW68151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical