MEDICARE: DR. KATHLEEN M. ZECHMEISTER 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	MFT25968	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MFT25968	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1154522142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN M. ZECHMEISTER MFT

Provider Business Mailing Address
First Line	:	5658 E DEBORAH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-1134
Country	:	US
Telephone Number	:	562-425-3242
Fax Number	:	562-596-8901

Provider Business Practice Location Address
First Line	:	5658 E DEBORAH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-1134
Country	:	US
Telephone Number	:	562-425-3242
Fax Number	:	562-596-8901

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	07/08/2007

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