1689570160 NPI number — PARADIGM SHIFT TALK LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689570160 NPI number — PARADIGM SHIFT TALK LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARADIGM SHIFT TALK LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689570160
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1310 SOUTH BEACH BLVD #1020 LA HABRA, CA 90631 UNITED
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITTIER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-979-3298
Provider Business Mailing Address Fax Number:
323-979-3298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6213 GRETNA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITTIER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90601-3130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-246-9871
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/20/2026

Additional Information

Authorized Official

Authorized Official Last Name:
ENCISO
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
HERNANDEZ
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
323-246-9871

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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