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NPI Code Detail

MEDICARE: TYLER MITCHELL-FOSTER

MEDICARE: TYLER MITCHELL-FOSTER
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
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1053860619
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER MITCHELL-FOSTER
Provider Business Mailing Address
First Line : 2130 N VENTURA RD
Second Line :
City : OXNARD
State : CA
Zip : 93036-2258
Country : US
Telephone Number : 510-317-1444
Fax Number :
Provider Business Practice Location Address
First Line : 2130 N VENTURA RD
Second Line :
City : OXNARD
State : CA
Zip : 93036-2258
Country : US
Telephone Number : 510-317-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2016
Last Update Date : 09/23/2016

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Directions to “ TYLER MITCHELL-FOSTER ” Practice Location

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