Edtna Bogarin
Rehabilitation Practitioner in Los Angeles, CA. Individual provider (NPI-1).
NPI number1699030833
StatusActive
Last updated in NPPESApr 16, 2025
Details
- NPI
- 1699030833
- Entity type
- Individual (NPI-1)
- Name
- Edtna Bogarin
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 12, 2012
- Certification date
- Apr 16, 2025
- Last updated
- Apr 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | CA | Yes |
| 106H00000X | Marriage & Family Therapist | 69143 | CA | |
| 171M00000X | Case Manager/Care Coordinator | – | CA | |
| 172V00000X | Community Health Worker | – | – |
Practice location
5110 W Goldleaf CirLos Angeles, CA 90056-1282
Phone 213-407-5598
Mailing address
5110 W Goldleaf Cir Fl 2Los Angeles, CA 90056-1282
Phone 213-407-5598
Other practice locations
42230 Lake Hughes Rd
Lake Hughes, CA 93532-1012
Lake Hughes, CA 93532-1012
Phone 661-724-8322
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