MEDICARE: MS. LUCYNA IGA GAJ M.A., MFT

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	MFC40850	CA

General Provider Information

NPI Number	:	1871525089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LUCYNA IGA GAJ M.A., MFT

Provider Business Mailing Address
First Line	:	PO BOX 9113
Second Line	:
City	:	MARINA DEL REY
State	:	CA
Zip	:	90295-1513
Country	:	US
Telephone Number	:	310-430-2701
Fax Number	:	310-574-9415

Provider Business Practice Location Address
First Line	:	400 CORPORATE POINTE
Second Line	:	AUCC
City	:	CULVER CITY
State	:	CA
Zip	:	90230-7615
Country	:	US
Telephone Number	:	310-430-2701
Fax Number	:	310-574-9415

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	04/24/2023

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