Basic Information
Provider Information
NPI: 1033642418
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORR
FirstName: VIOLA
MiddleName: ELISA
NamePrefix:  
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WITHINGTON
OtherFirstName: VIOLA
OtherMiddleName: ELISA
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 222 S HILL ST
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900123506
CountryCode: US
TelephoneNumber: 3104504050
FaxNumber:  
Practice Location
Address1: 222 S HILL ST
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900123506
CountryCode: US
TelephoneNumber: 3104504050
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/04/2017
LastUpdateDate: 04/04/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X  Y Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home