Provider Demographics
NPI:1427297910
Name:JAMORALIN, AGNES A (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AGNES
Middle Name:A
Last Name:JAMORALIN
Suffix:
Gender:F
Credentials:LCSW
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Other - Credentials:
Mailing Address - Street 1:9209 S. COLIMA RD
Mailing Address - Street 2:STE. 3600 TRIKORA BEHAVIORAL HEALTH & WELLNESS CENTER
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-1814
Mailing Address - Country:US
Mailing Address - Phone:562-696-0444
Mailing Address - Fax:562-696-0446
Practice Address - Street 1:9209 S. COLIMA RD
Practice Address - Street 2:SUITE 3600, TRIKORA BEHAVIORAL HEALTH & WELLNESS CENTER
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-1814
Practice Address - Country:US
Practice Address - Phone:562-696-0444
Practice Address - Fax:562-693-1184
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CALCS139781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS13978Medicare PIN