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NPI Code Detail

MEDICARE: ANDREA BRIGET GORDON L.M.F.T.

MEDICARE: ANDREA BRIGET GORDON L.M.F.T.
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 TherapistMFC30835CA

General Provider Information

NPI Number : 1295861854
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA BRIGET GORDON L.M.F.T.
Provider Business Mailing Address
First Line : 316 REDONDO AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90814-2651
Country : US
Telephone Number : 562-208-1985
Fax Number : 562-342-6607
Provider Business Practice Location Address
First Line : 316 REDONDO AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90814-2651
Country : US
Telephone Number : 562-208-1985
Fax Number : 562-342-6607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 07/08/2007

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