Organization
VETERANS ADMINISTRATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARTHA STEWART WAITE LCSW (CHIEF, SOCIAL WORK SERVICES)
(891) 891-7711
Entity
Organization
Contact information
Practice address
16111 PLUMMER ST, SEPULVEDA, CA 91343-2036
(818) 891-7711
Mailing address
16111 PLUMMER ST, BUILDING 10, SEPULVEDA, CA 91343-2036
(818) 891-7711
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
11181
PR
261QM0850X
Adult Mental Health Clinic/Center
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Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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