MEDICARE: LINDA E FUJINO AMFT

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	108935	CA

General Provider Information

NPI Number	:	1134762677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA E FUJINO AMFT

Provider Business Mailing Address
First Line	:	6695 E PACIFIC COAST HWY STE 135
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4235
Country	:	US
Telephone Number	:	562-431-5100
Fax Number	:	562-431-3560

Provider Business Practice Location Address
First Line	:	6695 E PACIFIC COAST HWY STE 135
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4235
Country	:	US
Telephone Number	:	562-431-5100
Fax Number	:	562-431-3560

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

Provider Enumeration Date	:	10/28/2019
Last Update Date	:	10/28/2019

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