Daz Foundation

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS11387 Issued in CA

Legal business name

DAZ FOUNDATION

Practice address

578 Washington Blvd # 815
Marina del Rey, CA 90292-5442

Phone

(323) 447-8372

NPI assigned

Nov 14, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ellen R Kimmel, LCSW

Title

Clinical Director

Phone

(323) 447-8372

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1225339872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 WASHINGTON BLVD # 815",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925442",
            "telephone_number": "323-447-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 WASHINGTON BLVD # 815",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925442",
            "telephone_number": "323-447-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAZ FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-14",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "323-447-8372",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS11387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.