Theodore Kurt Dietz, ACSW

NPI #1205589652 in Venice, California

Provider Information

NPI Number: 1205589652
Entity Type: Individual
Name: Theodore Kurt Dietz, ACSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: ACSW
Enumeration Date: Jan 26, 2022
Last Updated: Jun 23, 2023

Practice Location

Address: 204 HAMPTON DR
City: Venice
State: California
ZIP Code: 90291-8633
Phone: (310) 279-3499

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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