MEDICARE: MRS. GENESSA ZELLER 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	84785	CA

General Provider Information

NPI Number	:	1154510006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GENESSA ZELLER LMFT

Provider Business Mailing Address
First Line	:	227 BRIDGE ST
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-3311
Country	:	US
Telephone Number	:	805-904-4101
Fax Number	:

Provider Business Practice Location Address
First Line	:	227 BRIDGE ST
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-3311
Country	:	US
Telephone Number	:	805-904-4101
Fax Number	:

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

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	04/08/2025

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