MEDICARE: MS. ANGELA LU 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
1	106H00000X	Marriage & Family Therapist	LMFT 50019	CA

General Provider Information

NPI Number	:	1093852832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA LU LMFT

Provider Business Mailing Address
First Line	:	2746 E CAMERON AVE
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91791-2900
Country	:	US
Telephone Number	:	909-525-0827
Fax Number	:

Provider Business Practice Location Address
First Line	:	831 E ARROW HWY
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-2535
Country	:	US
Telephone Number	:	909-398-4383
Fax Number	:

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	01/09/2018

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