Ariel Escobedo, Licensed Clinical Social Worker Inc.

Organization Active NPI Community/Behavioral Health Agency · South Gate, CA

NPI 1659015162 · NPPES record last updated Apr 21, 2022

Key facts

NPI
1659015162
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
ARIEL ESCOBEDO, LICENSED CLINICAL SOCIAL WORKER INC.
Practice address
10320 Jackson Ave
South Gate, CA 90280-6904
Phone
(818) 554-6272
NPI assigned
Apr 21, 2022
Organization subpart
No

Authorized official

Name
Ariel Escobedo, LCSW
Title
President
Phone
(818) 554-6272

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220428002531 CA Part B Supplier - Clinic/Group Practice 9436546009 Receives reassigned benefits from 1 practitioner
Practice locations: South Gate, CA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

10320 Jackson Ave
South Gate, CA 90280-6904

Mailing address

10320 Jackson Ave
South Gate, CA 90280-6904
Phone (818) 554-6272

Other providers in South Gate, CA

All providers in South Gate, CA · Community/Behavioral Health Agency in California

Sources for this page

Verify at the official NPI Registry.