MEDICARE: MS. NORMA JEAN BRUNSELL 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	MFC24506	CA

General Provider Information

NPI Number	:	1578868261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NORMA JEAN BRUNSELL LMFT

Provider Business Mailing Address
First Line	:	1847 WESTMINSTER CT
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-5715
Country	:	US
Telephone Number	:	916-488-4120
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 AUBURN BLVD
Second Line	:	SUITE 203
City	:	SACRAMENTO
State	:	CA
Zip	:	95841-4103
Country	:	US
Telephone Number	:	916-488-4120
Fax Number	:

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

Provider Enumeration Date	:	01/11/2011
Last Update Date	:	01/11/2011

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