Provider Demographics
NPI:1780750638
Name:NEMETH SIMON, LISA ANNE (MSW)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANNE
Last Name:NEMETH SIMON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 RIVERSIDE DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505
Mailing Address - Country:US
Mailing Address - Phone:818-842-7174
Mailing Address - Fax:818-841-4344
Practice Address - Street 1:4405 RIVERSIDE DR
Practice Address - Street 2:SUITE 106
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505
Practice Address - Country:US
Practice Address - Phone:818-842-7174
Practice Address - Fax:818-841-4344
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS91651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical