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NPI Code Detail

MEDICARE: MEGAN HANSON

MEDICARE: MEGAN HANSON
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
1101YM0800XMental Health CounselorIMF79717CA
2106H00000XMarriage & Family TherapistLMFT101004CA

General Provider Information

NPI Number : 1568808467
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN HANSON
Provider Business Mailing Address
First Line : 3715 MIDDLEBURY ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-2312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2904 ROWENA AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90039-2042
Country : US
Telephone Number : 415-722-2248
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2013
Last Update Date : 01/03/2020

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