Vander Dale, LMSW, LCAC, CATC-IV,

NPI 1619241601 · on the registry since 2012

Practice

Address: 2090 River Avenue
Long Beach, CA 90810
Phone: (562) 826-8470
Fax: (562) 826-8485
Organisation at this address: Va Hospital - Long Beach
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 7

Registry record

Primary taxonomy: 104100000X
104100000X
Also registered as: 101Y00000X
Licence states on file: IN, TN
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-03-08

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