MEDICARE: MICHELLE KANE 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	166001050	IL
2	106H00000X	Marriage & Family Therapist	MFT-628	HI
3	106H00000X	Marriage & Family Therapist	T2011	OR
4	106H00000X	Marriage & Family Therapist	12007	CA

General Provider Information

NPI Number	:	1427493030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE KANE LMFT

Provider Business Mailing Address
First Line	:	30767 GATEWAY PL # 520
Second Line	:
City	:	RANCHO MISSION VIEJO
State	:	CA
Zip	:	92694-1856
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	27128A PASEO ESPADA # 1522
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-2725
Country	:	US
Telephone Number	:	949-391-9609
Fax Number	:

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

Provider Enumeration Date	:	05/08/2013
Last Update Date	:	02/05/2025

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