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SO. CAL. CHILD THERAPY NPI 1770975914


NPI Information

NPI: 1770975914
Provider Name: SO. CAL. CHILD THERAPY
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

CLIA Number: 05D0918313

Address:
6320 CANOGA AVE
15TH FLOOR
WOODLAND HILLS, CA
ZIP 91367
Phone: (818) 804-0322
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SO. CAL. CHILD THERAPY is a clinical social worker in Woodland Hills, 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. SO. CAL. CHILD THERAPY NPI is 1770975914. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6320 CANOGA AVE
15TH FLOOR
WOODLAND HILLS, CA
ZIP 91367-526
Phone: (818) 804-0322

The provider's authorized official is Beth Jakubanis .
The authorized official title is Clinical Director and has the following contact phone number (818) 804-0322.

The CLIA number assigned to this NPI record is 05D0918313 - health maintenance organization with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/25/2015 and was last updated on 2/25/2015.


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
11041S0200XSocial WorkerSchoolLCS 28234CALIFORNIANo
21041C0700XSocial WorkerClinicalLCS 28234CALIFORNIAYes

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
11700079191OTHERINDIVIDUAL NPI NUMBER

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.