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NPI Code Detail

MEDICARE: CAROLYN HALL M.A.

MEDICARE: CAROLYN HALL M.A.
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
1106H00000XMarriage & Family Therapist36665CA

General Provider Information

NPI Number : 1548566037
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN HALL M.A.
Provider Business Mailing Address
First Line : 1000 PASEO CAMARILLO
Second Line : SUITE 205
City : CAMARILLO
State : CA
Zip : 93010-6021
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 PASEO CAMARILLO
Second Line : SUITE 205
City : CAMARILLO
State : CA
Zip : 93010-6021
Country : US
Telephone Number : 805-388-3835
Fax Number : 805-233-7933
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2011
Last Update Date : 02/01/2011

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