MEDICARE: EILEEN BEIRICH MFT

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	33187	CA

General Provider Information

NPI Number	:	1134138233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN BEIRICH MFT

Provider Business Mailing Address
First Line	:	2130 E MOUNTAIN ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-4129
Country	:	US
Telephone Number	:	626-794-8120
Fax Number	:

Provider Business Practice Location Address
First Line	:	595 E COLORADO BLVD
Second Line	:	SUITE 620
City	:	PASADENA
State	:	CA
Zip	:	91101-2039
Country	:	US
Telephone Number	:	626-296-3594
Fax Number	:

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	07/08/2007

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Directions to “ EILEEN BEIRICH MFT” Practice Location

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