MEDICARE: MR. DUSTIN SCHIADA MA

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	37754	CA

General Provider Information

NPI Number	:	1164551354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DUSTIN SCHIADA MA

Provider Business Mailing Address
First Line	:	6512 BRIGHT AVE STE A
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-4503
Country	:	US
Telephone Number	:	951-218-2561
Fax Number	:

Provider Business Practice Location Address
First Line	:	6512 BRIGHT AVE STE A
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-4503
Country	:	US
Telephone Number	:	951-218-2561
Fax Number	:

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

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