Provider Demographics
NPI:1285078915
Name:NELSON, LATOYA LATRECE MCCLAIN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:LATRECE MCCLAIN
Last Name:NELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LATOYA
Other - Middle Name:LATRECE
Other - Last Name:MCCLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:20101 HAMILTON AVE STE 155
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1314
Mailing Address - Country:US
Mailing Address - Phone:213-435-4397
Mailing Address - Fax:
Practice Address - Street 1:20101 HAMILTON AVE STE 155
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1314
Practice Address - Country:US
Practice Address - Phone:213-435-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA831441041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker