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NPI Code Detail

MEDICARE: RITA ISABEL MCKINNEY LMFT

MEDICARE: RITA ISABEL MCKINNEY LMFT
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 Therapist99697CA

General Provider Information

NPI Number : 1952741506
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA ISABEL MCKINNEY LMFT
Provider Business Mailing Address
First Line : 1099 TAUTOG CIR
Second Line :
City : SILVERDALE
State : WA
Zip : 98315-1012
Country : US
Telephone Number : 360-315-3070
Fax Number :
Provider Business Practice Location Address
First Line : 2130 NATIONAL AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-2209
Country : US
Telephone Number : 619-255-5172
Fax Number : 619-269-0464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2013
Last Update Date : 06/24/2019

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