1619097276 NPI number — MRS. RUSSANA LOUSIE ROWLES SOC WKR LCSW

Table of content: MRS. RUSSANA LOUSIE ROWLES SOC WKR LCSW (NPI 1619097276)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619097276 NPI number — MRS. RUSSANA LOUSIE ROWLES SOC WKR LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROWLES
Provider First Name:
RUSSANA
Provider Middle Name:
LOUSIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
SOC WKR LCSW
Provider Gender Code:
F

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:
1619097276
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
USC SCHOOL OF SOCIAL WORK FIELD DEPARTMENT
Provider Second Line Business Mailing Address:
669 WEST 34TH STREET, MRF
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90089-0411
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-740-1424
Provider Business Mailing Address Fax Number:
213-740-0789

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USC SCHOOL OF SOCIAL WORK FIELD DEPARTMENT
Provider Second Line Business Practice Location Address:
669 WEST 34TH STREET, MRF
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90089-0411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-740-1424
Provider Business Practice Location Address Fax Number:
213-740-0789
Provider Enumeration Date:
03/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  14087 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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