MEDICARE: MARJORIE WARREN MFC

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	MFC36410	CA

General Provider Information

NPI Number	:	1780800698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARJORIE WARREN MFC

Provider Business Mailing Address
First Line	:	502 VILLAGE RD
Second Line	:
City	:	PORT HUENEME
State	:	CA
Zip	:	93041-3035
Country	:	US
Telephone Number	:	818-451-7102
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 CARMEN DR STE 115D
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-3103
Country	:	US
Telephone Number	:	818-451-7102
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	06/29/2026

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