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NPI Code Detail

MEDICARE: SYNTHIA JOHANN TERCERO LMFT115930

MEDICARE: SYNTHIA JOHANN TERCERO LMFT115930
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 TherapistIMF87315CA
2106H00000XMarriage & Family TherapistLMFT115930CA

General Provider Information

NPI Number : 1922481795
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYNTHIA JOHANN TERCERO LMFT115930
Provider Business Mailing Address
First Line : 3435 WILSHIRE BLVD STE 1840
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-2004
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3435 WILSHIRE BLVD STE 1840
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-2004
Country : US
Telephone Number : 323-382-7658
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2015
Last Update Date : 05/13/2025

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