MEDICARE: MISS RAMONA WELLS MA

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	79416	CA

General Provider Information

NPI Number	:	1538219902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS RAMONA WELLS MA

Provider Business Mailing Address
First Line	:	3031 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90007-3033
Country	:	US
Telephone Number	:	323-290-8360
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 CRENSHAW BLVD
Second Line	:	SUITE 300
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-1227
Country	:	US
Telephone Number	:	323-290-8360
Fax Number	:

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	11/08/2016

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Directions to “ MISS RAMONA WELLS MA” Practice Location

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