MEDICARE: RUTH ELAINE LYNCH 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
1	106H00000X	Marriage & Family Therapist	47327	CA

General Provider Information

NPI Number	:	1366674400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH ELAINE LYNCH LMFT

Provider Business Mailing Address
First Line	:	6700 E PACIFIC COAST HWY
Second Line	:	SUITE 104
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4212
Country	:	US
Telephone Number	:	714-916-4358
Fax Number	:

Provider Business Practice Location Address
First Line	:	6700 E PACIFIC COAST HWY
Second Line	:	SUITE 104
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4212
Country	:	US
Telephone Number	:	714-916-4358
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2009
Last Update Date	:	08/21/2009

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