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NPI Code Detail

MEDICARE: MS. MICHELLE DAWN KLINE M.A., LMFT

MEDICARE: MS. MICHELLE DAWN KLINE M.A., 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
1106H00000XMarriage & Family Therapist52573CA

General Provider Information

NPI Number : 1205099504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE DAWN KLINE M.A., LMFT
Provider Business Mailing Address
First Line : 6970 FORUM ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-3325
Country : US
Telephone Number : 619-840-5034
Fax Number :
Provider Business Practice Location Address
First Line : 1341 N ESCONDIDO BLVD
Second Line :
City : ESCONDIDO
State : CA
Zip : 92026-2507
Country : US
Telephone Number : 760-317-9120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2008
Last Update Date : 05/24/2016

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