Individual
AVIAN WEISWERDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
849 E 6TH ST, LOS ANGELES, CA 90021-1026
(213) 623-8446
Mailing address
849 E 6TH ST, LOS ANGELES, CA 90021-1026
(213) 623-8446
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
79694
CA
1041C0700X
Clinical Social Worker
Primary
LCSW100125
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700
—
CA
Enumeration date
06/15/2016
Last updated
07/30/2021
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