Provider Demographics
NPI:1053418772
Name:EINHORN, JILL (LCSW)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:
Last Name:EINHORN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18401 BURBANK BL
Mailing Address - Street 2:ST 219
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356
Mailing Address - Country:US
Mailing Address - Phone:818-609-1424
Mailing Address - Fax:818-609-1450
Practice Address - Street 1:18401 BURBANK BL
Practice Address - Street 2:ST 219
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-609-1424
Practice Address - Fax:818-609-1450
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL61401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW6140Medicare ID - Type Unspecified