Provider Demographics
NPI:1053545004
Name:LUJAN, JOSE (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:
Last Name:LUJAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13337 SOUTH ST
Mailing Address - Street 2:STE. 130
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7308
Mailing Address - Country:US
Mailing Address - Phone:562-860-7051
Mailing Address - Fax:
Practice Address - Street 1:5230 E BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-2002
Practice Address - Country:US
Practice Address - Phone:323-724-0019
Practice Address - Fax:323-724-3539
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS101851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical