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General NPI Number Information
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NPI Number | 1245357136
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Entity Type | Individual
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Provider Name | MIRTHA BELLIDO M.S.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 4300 LONG BEACH BLVD STE 700
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City | LONG BEACH
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State | CA
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Zip | 90807-2000
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Country | US
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Telephone | 213-385-5100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 934
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City | SOUTH PASADENA
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State | CA
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Zip | 91031-0934
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Country | US
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Telephone | 213-385-5100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 49240
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License Number State | CA
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