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NPI Code Detail

MEDICARE: JOAN S SUN MFT

MEDICARE:   JOAN S SUN  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
1106H00000XMarriage & Family TherapistMFT28760CA

General Provider Information

NPI Number : 1881710390
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN S SUN MFT
Provider Business Mailing Address
First Line : 1314 WESTWOOD BLVD
Second Line : 104
City : LOS ANGELES
State : CA
Zip : 90024-4902
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1314 WESTWOOD BLVD
Second Line : 104
City : LOS ANGELES
State : CA
Zip : 90024-4902
Country : US
Telephone Number : 310-470-5935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 07/08/2007

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Directions to “ JOAN S SUN MFT” Practice Location

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