MEDICARE: NATALIE MARIE FERBEZAR ASW

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	101YM0800X	Mental Health Counselor	72196	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	190116	OTHER		PROVIDER NUMBER VOLUNTEERS OF AMERICA

General Provider Information

NPI Number	:	1790227593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE MARIE FERBEZAR ASW

Provider Business Mailing Address
First Line	:	7986 DAGGET ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2321
Country	:	US
Telephone Number	:	858-262-8504
Fax Number	:

Provider Business Practice Location Address
First Line	:	4969 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5813
Country	:	US
Telephone Number	:	213-286-0324
Fax Number	:

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

Provider Enumeration Date	:	11/09/2016
Last Update Date	:	05/22/2019

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