Provider Demographics
NPI:1730565151
Name:PAMELA H PAIGE, LCSW
Entity type:Organization
Organization Name:PAMELA H PAIGE, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE PRACTICE
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LCSW
Authorized Official - Phone:310-395-0454
Mailing Address - Street 1:1460 7TH ST
Mailing Address - Street 2:301
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2629
Mailing Address - Country:US
Mailing Address - Phone:310-395-0454
Mailing Address - Fax:
Practice Address - Street 1:1460 7TH ST
Practice Address - Street 2:301
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2629
Practice Address - Country:US
Practice Address - Phone:310-395-0454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS55731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS5573OtherPRIVATE PRACTICE