Provider Demographics
NPI:1871340299
Name:MALLOY, HILARY (SOCIAL WORKER (ASW))
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:MALLOY
Suffix:
Gender:F
Credentials:SOCIAL WORKER (ASW)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4765 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-4951
Mailing Address - Country:US
Mailing Address - Phone:323-806-3829
Mailing Address - Fax:
Practice Address - Street 1:2301 HYPERION AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-4711
Practice Address - Country:US
Practice Address - Phone:800-726-3890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW115261104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker