MEDICARE: LYNN JENKINS FEINBERG LYNN FEINBERG

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	MFC14007	CA

General Provider Information

NPI Number	:	1932303302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN JENKINS FEINBERG LYNN FEINBERG

Provider Business Mailing Address
First Line	:	5716 HARDY AVENUE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115
Country	:	US
Telephone Number	:	619-846-9686
Fax Number	:	619-594-4315

Provider Business Practice Location Address
First Line	:	5716 HARDY AVENUE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-1314
Country	:	US
Telephone Number	:	619-846-9686
Fax Number	:	619-594-4315

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

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	07/08/2007

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