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NPI Code Detail

MEDICARE: JETENA MICHELLE MCGHEE

MEDICARE: JETENA MICHELLE MCGHEE
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
11041C0700XClinical Social Worker73385CA
2101YM0800XMental Health Counselor31922CA

General Provider Information

NPI Number : 1245548767
Entity Type Code : Individual
Provider Name (Legal Business Name) : JETENA MICHELLE MCGHEE
Provider Business Mailing Address
First Line : 6080 CENTER DR FL 6
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-9205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6080 CENTER DR FL 6
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-9205
Country : US
Telephone Number : 424-209-8333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2010
Last Update Date : 11/20/2025

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Directions to “ JETENA MICHELLE MCGHEE ” Practice Location

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