MEDICARE: MARY LAUREN FLOCCA 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	144308	CA

General Provider Information

NPI Number	:	1821340258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY LAUREN FLOCCA LMFT

Provider Business Mailing Address
First Line	:	PO BOX 14759
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90853-4759
Country	:	US
Telephone Number	:	562-310-2880
Fax Number	:

Provider Business Practice Location Address
First Line	:	3215 E BROADWAY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5817
Country	:	US
Telephone Number	:	562-449-3936
Fax Number	:

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

Provider Enumeration Date	:	10/09/2012
Last Update Date	:	05/05/2025

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