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NPI Code Detail

MEDICARE: MS. PATRICIA MANDATORI MFTI

MEDICARE: MS. PATRICIA MANDATORI MFTI
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
1106H00000XMarriage & Family Therapist
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1114046182
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA MANDATORI MFTI
Provider Business Mailing Address
First Line : 838 E 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90021-1028
Country : US
Telephone Number : 213-623-8446
Fax Number : 213-896-1880
Provider Business Practice Location Address
First Line : 838 E 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90021-1028
Country : US
Telephone Number : 213-623-8446
Fax Number : 213-896-1880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 05/03/2013

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