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Individual

BERTHA ALICIA BANUELOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, PPSC

Contact information

Practice address
3026 MALABAR ST, LOS ANGELES, CA 90063-4017
(323) 973-3691
Mailing address
3026 MALABAR ST, LOS ANGELES, CA 90063-4017
(323) 973-3691

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
130628
CA

Other

Enumeration date
01/20/2026
Last updated
01/20/2026
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