Individual
CAMILLE J FAGENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
2400 MISSION ST, SAN MARINO, CA 91108-1632
(626) 403-8999
(626) 403-8989
Mailing address
2400 MISSION ST, SAN MARINO, CA 91108-1632
(626) 403-8999
(626) 403-8989
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS14489
CA
Other
Enumeration date
03/01/2007
Last updated
11/26/2007
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