CorpID/LocID

Practitioner List:

 PHOENIX HOUSES OF LOS ANGELES, INC.
 11600 Eldridge Avenue,
 Lake View Terrace, CA  91342

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First NameLast NamePractitioner TypeNPICalifornia License NumberCalifornia License TypeCultural Competence Training
CarolynWickersham Nurse Practitioner (NP) 1073936712 California Board of Registered Nursing (NP and RN)Yes
JAMESMONGE Licensed Eligible Practitioner working under the supervision of a Licensed Clinician 1063935799 Board of Behavioral Sciences (LCSW, LPCC, LMFT)Yes
JENNYSANCHEZ Licensed Marriage and Family Therapist (LMFT) 1922444827 Board of Behavioral Sciences (LCSW, LPCC, LMFT)Yes
JOSEHERNANDEZ Licensed Eligible Practitioner working under the supervision of a Licensed Clinician 1326684655 Board of Behavioral Sciences (LCSW, LPCC, LMFT)Yes
MARIAGARCIA Licensed Eligible Practitioner working under the supervision of a Licensed Clinician 1588177513 Board of Behavioral Sciences (LCSW, LPCC, LMFT)Yes
MELODYRAZI Licensed Eligible Practitioner working under the supervision of a Licensed Clinician 1427647890 Board of Behavioral Sciences (LCSW, LPCC, LMFT)Yes
MICHAELCARDELLA Licensed Eligible Practitioner working under the supervision of a Licensed Clinician 1861198533 Board of Behavioral Sciences (LCSW, LPCC, LMFT)Yes
TRAVISBLAIR Licensed Eligible Practitioner working under the supervision of a Licensed Clinician 1043762321 Board of Behavioral Sciences (LCSW, LPCC, LMFT)Yes