Diana Acevedo Selover, LCSW

Individual provider Active NPI Clinical Social Worker · Sepulveda, CA

NPI 1386757367 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1386757367
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCS9578 (CA)
Practice address
16111 Plummer St
Building 10
Sepulveda, CA 91343-2036
Phone
(818) 891-7711
Fax
(818) 895-5858
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LCS9578CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Veterans Administration Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS9578 CA Yes

Addresses

Primary practice location

16111 Plummer St
Building 10
Sepulveda, CA 91343-2036

Mailing address

1167 E Badillo St Apt a
Covina, CA 91724-3012
Phone (626) 332-4579

Other providers in Sepulveda, CA

All providers in Sepulveda, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.