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NPI Code Detail

MEDICARE: SYLVIA FONTICIELLA

MEDICARE: SYLVIA FONTICIELLA
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1013345016
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYLVIA FONTICIELLA
Provider Business Mailing Address
First Line : 2010 LINCOLN PARK AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3119
Country : US
Telephone Number : 323-222-1440
Fax Number :
Provider Business Practice Location Address
First Line : 2010 LINCOLN PARK AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3119
Country : US
Telephone Number : 323-222-1440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2013
Last Update Date : 07/26/2019

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Directions to “ SYLVIA FONTICIELLA ” Practice Location

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