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JANICE DERDERIAN LICENSED CLINICAL SOCIAL WORKER INC NPI 1700072717


NPI Information

NPI: 1700072717
Provider Name: JANICE DERDERIAN LICENSED CLINICAL SOCIAL WORKER INC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
1661 GOLDEN RAIN RD
SEAL BEACH, CA
ZIP 90740
Phone: (562) 795-6300
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JANICE DERDERIAN LICENSED CLINICAL SOCIAL WORKER INC is a clinical social worker in Seal Beach, CA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. JANICE DERDERIAN LICENSED CLINICAL SOCIAL WORKER INC NPI is 1700072717. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1661 GOLDEN RAIN RD
SEAL BEACH, CA
ZIP 90740-907
Phone: (562) 795-6300

The provider's authorized official is Janice Derderian .
The authorized official title is Owner and has the following contact phone number (562) 795-6300.

The enumeration date for this NPI number is 9/24/2007 and was last updated on 9/24/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalSW7388CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W18558MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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