Provider Demographics
NPI:1386170934
Name:TRACY HOBERMAN, LCSW
Entity type:Organization
Organization Name:TRACY HOBERMAN, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:HOBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:818-326-0449
Mailing Address - Street 1:7705 MARLBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-5234
Mailing Address - Country:US
Mailing Address - Phone:818-326-0449
Mailing Address - Fax:818-346-4274
Practice Address - Street 1:7705 MARLBOROUGH CT
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-5234
Practice Address - Country:US
Practice Address - Phone:818-326-0449
Practice Address - Fax:818-346-4274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS162721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty