Individual
AISHA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5739 CHESLEY AVE, LOS ANGELES, CA 90043-2423
(213) 671-1509
Mailing address
5739 CHESLEY AVE, LOS ANGELES, CA 90043-2423
(213) 671-1509
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
CA
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Enumeration date
11/02/2022
Last updated
04/24/2025
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