MEDICARE: MS. ERIN KATHLEEN BUNNELL MA, 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	MFC 37182	CA
2	106H00000X	Marriage & Family Therapist	2878-R	NV

General Provider Information

NPI Number	:	1205855590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIN KATHLEEN BUNNELL MA, LMFT

Provider Business Mailing Address
First Line	:	201 RIVER RD
Second Line	:
City	:	DAYTON
State	:	NV
Zip	:	89403-7700
Country	:	US
Telephone Number	:	805-714-6200
Fax Number	:	805-268-7013

Provider Business Practice Location Address
First Line	:	201 RIVER RD
Second Line	:
City	:	DAYTON
State	:	NV
Zip	:	89403-7700
Country	:	US
Telephone Number	:	805-714-6200
Fax Number	:	805-268-7013

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/01/2022

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