Kim Prodger is a Clinical in Lakewood, California. Kim Prodger practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kim Prodger is 1114066404. The last update date is 2007-07-08.
Kim Prodger's current location address is 4010 Watson Plaza Dr, Lakewood, California. You can contact this provider via phone number 5624971505 and fax number 5624971881. The mailing address for Kim Prodger is 4010 Watson Plaza Dr, Lakewood, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kim Prodger |
|---|---|
| Address | 4010 Watson Plaza Dr, Lakewood, California |
| Phone Number | 5624971505 |
| Fax Number | 5624971881 |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1114066404 |
|---|---|
| Provider Enumeration Date | 2007-02-05 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4010 Watson Plaza Dr |
|---|---|
| City | Lakewood |
| State | California (CA) |
| Post Code | 907124037 |
| Phone Number | 5624971505 |
| Fax Number | 5624971881 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCS 12046 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique identifier code issued to Kim Prodger by the Centers for Medicare & Medicaid Services?
The Kim Prodger has been assigned the NPI (National Provider Identifier) 1114066404. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Kim Prodger is geographically located?
The Kim Prodger is physically situated at the following location: 4010 Watson Plaza Dr, Lakewood, CA, 907124037.
What is Kim Prodger's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Kim Prodger is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
On what date did the Kim Prodger receive the assignment of its 1114066404 from the Centers for Medicare & Medicaid Services?
The Kim Prodger was issued its 1114066404 by the Centers for Medicare & Medicaid Services on 2007-02-05.
When was the information regarding Kim Prodger most recently updated?
The details pertaining to the Kim Prodger, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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