Bustamante, Miriam Leah
Bustamante, Miriam Leah is an sole proprietor health care provider with primary practice located at 24311 Santa Clara Ave Apt 1 , Dana Point CA 92629-3019. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bustamante, Miriam Leah can be contacted via phone (714) 200-6219.Contact Information
Primary practice address
24311 Santa Clara Ave Apt 1
Dana Point CA 92629-3019
Phone: (714) 200-6219
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 88666 | California |
Profile Details
| NPI number | 1447950860 |
|---|---|
| LBN Legal business name | Bustamante, Miriam Leah |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 6th, 2023 |
| Last updated | Apr 12th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447950860 | NPPES |
| California | Other | 88666 | BBS |
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