Provider Demographics
NPI:1912136821
Name:ADAMS, ANASTASIA BERNADETTE
Entity Type:Individual
Prefix:MS
First Name:ANASTASIA
Middle Name:BERNADETTE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11234 VALLEY BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-3241
Mailing Address - Country:US
Mailing Address - Phone:626-575-4001
Mailing Address - Fax:626-443-1040
Practice Address - Street 1:9150 IMPERIAL HWY
Practice Address - Street 2:ROOM P-31
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2835
Practice Address - Country:US
Practice Address - Phone:562-940-3694
Practice Address - Fax:562-658-7425
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator