Costa Via is a Peer Specialist based in Lawndale, CA. Costa Via practices in Lawndale, CA. The NPI Number for Costa Via is 1497523682 and holds a License No. MPSS-HNGJYI (California).
The current practice location address for Costa Via is 4580 W 173Rd St Apt 115, Lawndale, CA and can be reached out via phone at 310-421-4233.
Location: 4580 W 173Rd St Apt 115, Lawndale, CA, 90260-3440
Provider Profile Details
NPI Number
1497523682
Provider Name
Costa Via
Credential
Provider Entity Type
Individual
Gender
Male
Address
4580 W 173Rd St Apt 115, Lawndale, CA, 90260-3440
Phone Number
310-421-4233
Fax Number
Provider Enumeration Date
12/18/2023
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
4580 W 173Rd St Apt 115
City
State
Zip
90260-3440
Phone Number
310-421-4233
Fax Number
Provider Business Mailing Address Details
Address
4580 W 173Rd St Apt 115
City
State
Zip
90260-3440
Phone Number
310-421-4233
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
MPSS-HNGJYI (California)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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