1578716718 NPI number — MRS. SUSANNA GIULIANO-GHAHRAMANI MSW

Table of content: MRS. SUSANNA GIULIANO-GHAHRAMANI MSW (NPI 1578716718)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578716718 NPI number — MRS. SUSANNA GIULIANO-GHAHRAMANI MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIULIANO-GHAHRAMANI
Provider First Name:
SUSANNA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GIULIANO
Provider Other First Name:
SUSANNA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1578716718
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
915 W FOOTHILL BLVD STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLAREMONT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91711-3356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-500-5208
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 BAUCHET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90012-2907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-473-6184
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  ASW-20054 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)