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Search › California › 101YA0400X

Avery Wortham

NPI 1639937907 · on the registry since 2024

Practice

Address
503 Ocean Front Walk
Venice, CA 90291
Phone
(310) 392-3070
Organisation at this address
Phoenix Houses Of Los Angeles, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
78

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Licence states on file
NULL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-03-11
Status
Not present in the most recent federal file

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California