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NPI Code Detail

MEDICARE: MR. GLENN PHILIP FERDINAND M.S., LMFT

MEDICARE: MR. GLENN PHILIP FERDINAND M.S., LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist94192CA

General Provider Information

NPI Number : 1245417567
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GLENN PHILIP FERDINAND M.S., LMFT
Provider Business Mailing Address
First Line : 555 E OCEAN BLVD STE 330
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-5052
Country : US
Telephone Number : 562-424-1869
Fax Number :
Provider Business Practice Location Address
First Line : 555 E OCEAN BLVD STE 330
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-5052
Country : US
Telephone Number : 562-432-1222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2008
Last Update Date : 03/23/2022

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