Basic Information
Provider Information
NPI: 1366784175
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROJAS
FirstName: HANNAH
MiddleName: MELISSA
NamePrefix:  
NameSuffix:  
Credential: ASW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3727 W 6TH ST
Address2: SUITE 411
City: LOS ANGELES
State: CA
PostalCode: 900205105
CountryCode: US
TelephoneNumber: 2133657400
FaxNumber: 2132013993
Practice Location
Address1: 3727 W 6TH ST
Address2: SUITE 411
City: LOS ANGELES
State: CA
PostalCode: 900205105
CountryCode: US
TelephoneNumber: 2133657400
FaxNumber: 2132013993
Other Information
ProviderEnumerationDate: 03/19/2013
LastUpdateDate: 03/19/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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