Provider Demographics
NPI:1205962461
Name:MUNOZ, ELVIRA (LCSW)
Entity type:Individual
Prefix:
First Name:ELVIRA
Middle Name:
Last Name:MUNOZ
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 1:97 W BELLEVUE DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2501
Mailing Address - Country:US
Mailing Address - Phone:818-548-7780
Mailing Address - Fax:626-795-3527
Practice Address - Street 1:97 W BELLEVUE DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2501
Practice Address - Country:US
Practice Address - Phone:818-548-7780
Practice Address - Fax:626-795-3527
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS124061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical