MEDICARE: DIANA AFARI M.F.C.C.

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	29387	CA

General Provider Information

NPI Number	:	1528381563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA AFARI M.F.C.C.

Provider Business Mailing Address
First Line	:	10940 WILSHIRE BLVD
Second Line	:	SUITE 1600
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-3915
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10940 WILSHIRE BLVD
Second Line	:	SUITE 1600
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-3915
Country	:	US
Telephone Number	:	310-443-4165
Fax Number	:

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

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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