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NPI Code Detail

MEDICARE: RONI B MACCABEE PHD

MEDICARE: RONI B MACCABEE PHD
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
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator
3103TC0700XClinical PsychologistPSY32255CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093931115
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONI B MACCABEE PHD
Provider Business Mailing Address
First Line : 3580 WILSHIRE BLVD STE 2000
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-2533
Country : US
Telephone Number : 213-381-1250
Fax Number : 213-383-4803
Provider Business Practice Location Address
First Line : 3580 WILSHIRE BLVD STE 2000
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-2533
Country : US
Telephone Number : 213-381-1250
Fax Number : 213-383-4803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 01/14/2021

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Directions to “ RONI B MACCABEE PHD” Practice Location

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