Provider Demographics
NPI:1457524423
Name:NALLSDEMAR, BELVERLY SUE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BELVERLY
Middle Name:SUE
Last Name:NALLSDEMAR
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 1:12881 FERN ST
Mailing Address - Street 2:#D
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-4331
Mailing Address - Country:US
Mailing Address - Phone:714-615-5252
Mailing Address - Fax:714-622-4806
Practice Address - Street 1:12881 FERN ST
Practice Address - Street 2:#D
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4331
Practice Address - Country:US
Practice Address - Phone:714-615-5252
Practice Address - Fax:714-622-4806
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 144531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical