MEDICARE: MISS CATALINA VELA M.A.

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	47228	CA

General Provider Information

NPI Number	:	1871806075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CATALINA VELA M.A.

Provider Business Mailing Address
First Line	:	PO BOX 711843
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92171-1843
Country	:	US
Telephone Number	:	619-456-7746
Fax Number	:

Provider Business Practice Location Address
First Line	:	1012 C ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-5522
Country	:	US
Telephone Number	:	619-456-7746
Fax Number	:

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

Provider Enumeration Date	:	07/16/2010
Last Update Date	:	07/16/2010

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