MEDICARE: JEAN PAPPALARDO 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	94424	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831520121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN PAPPALARDO LMFT

Provider Business Mailing Address
First Line	:	11600 WASHINGTON PL STE 203
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-5068
Country	:	US
Telephone Number	:	323-553-1971
Fax Number	:	310-564-2280

Provider Business Practice Location Address
First Line	:	11600 WASHINGTON PL STE 203
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-5068
Country	:	US
Telephone Number	:	323-553-1971
Fax Number	:	310-564-2280

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

Provider Enumeration Date	:	12/11/2013
Last Update Date	:	12/10/2019

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