MEDICARE: MS. TURTLE K A. KLEIN

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	RI-K0701301324	CA

General Provider Information

NPI Number	:	1639214539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TURTLE K A. KLEIN

Provider Business Mailing Address
First Line	:	226 N L ST
Second Line	:
City	:	LOMPOC
State	:	CA
Zip	:	93436-5902
Country	:	US
Telephone Number	:	805-735-1802
Fax Number	:

Provider Business Practice Location Address
First Line	:	226 N L ST
Second Line	:	218 NORTH I STREET
City	:	LOMPOC
State	:	CA
Zip	:	93436-5902
Country	:	US
Telephone Number	:	805-735-1802
Fax Number	:

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/10/2007

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