| Provider / Organization | NPI | Date Certified |
|---|---|---|
| AMBER GORDON | 1356945281 | 2020-11-22 |
| Entity Type | Individual |
| Provider Name | Amber Gordon ACSW |
| Practice Office Address | 210 N PASS AVE STE 202 BURBANK, CA US |
| Practice Office Telephone | 8865748814 |
| Mailing Address | 1349 N CHEROKEE AVE APT 203 LOS ANGELES, CA 900287747 US |
| Business Telephone | 9096801380 |
| Code | License No | State |
|---|---|---|
| 1041C0700X PRIMARY |