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Individual

ANGELA BONACQUISTI FARRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
300 MEDICAL PLZ, LOS ANGELES, CA 90095-0001
(310) 825-9989
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 825-9989

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LCS7406
CA
1041C0700X
Clinical Social Worker
Primary
LCS7406
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LCS740600
MEDICAL
CA
Enumeration date
08/24/2006
Last updated
07/10/2013
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