Provider Demographics
NPI:1336256999
Name:POZO HUMPHREYS, MARIA ROSARIO (LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ROSARIO
Last Name:POZO HUMPHREYS
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ROSARIO
Other - Last Name:POZO HUMPHREYS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:800 W 1ST ST UNIT 1805
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2481
Mailing Address - Country:US
Mailing Address - Phone:562-234-1999
Mailing Address - Fax:
Practice Address - Street 1:611 WILSHIRE BLVD STE 309
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2908
Practice Address - Country:US
Practice Address - Phone:562-234-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 141571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical