Most Relevant Information
Provider Data
| NPI Number: | 1003309725 |
| Provider Name: | SUSANA RABENA BUSTAMANTE LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/07/2018 |
| Last Updated: | 08/14/2018 |
Provider Practice Location
333 S BEAUDRY AVE
LOS ANGELES
CA
90017
Practice Location Phone/Fax
| Phone: | 2132413841 |
| Fax: | 2132413305 |
Provider Mailing Location
333 S BEAUDRY AVE
LOS ANGELES
CA
900171466
Provider Mailing Phone/Fax
| Phone: | 2132413841 |
| Fax: | 2132413305 |