MEDICARE: MADONNA MARGARET NAVARRO 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	124660	CA
2	106H00000X	Marriage & Family Therapist	IMF99381	CA
3	101Y00000X	Counselor

General Provider Information

NPI Number	:	1497279129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADONNA MARGARET NAVARRO LMFT

Provider Business Mailing Address
First Line	:	1550 CANYON DEL REY BLVD # 1062
Second Line	:
City	:	SEASIDE
State	:	CA
Zip	:	93955-3501
Country	:	US
Telephone Number	:	831-295-5784
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 CANYON DEL REY BLVD # 1062
Second Line	:
City	:	SEASIDE
State	:	CA
Zip	:	93955-3501
Country	:	US
Telephone Number	:	831-295-5784
Fax Number	:

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

Provider Enumeration Date	:	08/03/2017
Last Update Date	:	05/18/2026

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