Individual
MS. RAVEN ALANNAH WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45111 FERN AVE, LANCASTER, CA 93534-2301
(661) 949-1206
(661) 940-5452
Mailing address
45111 FERN AVE, LANCASTER, CA 93534-2301
(661) 949-1206
(661) 940-5452
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
16222
CA
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
11/09/2019
Last updated
04/02/2024
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