MEDICARE: MS. MARGARET BEDROSIAN LCSW

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	101YM0800X	Mental Health Counselor	LCS11814	CA

General Provider Information

NPI Number	:	1235204579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET BEDROSIAN LCSW

Provider Business Mailing Address
First Line	:	333 OLIVE ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-6215
Country	:	US
Telephone Number	:	619-295-8002
Fax Number	:	619-295-8098

Provider Business Practice Location Address
First Line	:	333 OLIVE ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-6215
Country	:	US
Telephone Number	:	619-295-8002
Fax Number	:	619-295-8098

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	07/08/2007

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