Provider Demographics
NPI: | 1316327075 |
---|---|
Name: | ARAUJO, LOURDES ENCARNACION |
Entity type: | Individual |
Prefix: | MS |
First Name: | LOURDES |
Middle Name: | ENCARNACION |
Last Name: | ARAUJO |
Suffix: | |
Gender: | F |
Credentials: | |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 5000 W SUNSET BLVD STE 600 |
Mailing Address - Street 2: | |
Mailing Address - City: | LOS ANGELES |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90027-5863 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 213-392-5500 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 550 S VERMONT AVE 3RD FLOOR |
Practice Address - Street 2: | |
Practice Address - City: | LOS ANGELES, |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90020 |
Practice Address - Country: | US |
Practice Address - Phone: | 213-639-0677 |
Practice Address - Fax: | 213-637-0790 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2015-06-08 |
Last Update Date: | 2025-05-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | ASW 29721 | 1041C0700X |
225400000X, 171M00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |