MEDICARE: MS. KAREN LYNN WIENER MA,M.F.T., CMC

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	MFC42683	CA

General Provider Information

NPI Number	:	1265565303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN LYNN WIENER MA,M.F.T., CMC

Provider Business Mailing Address
First Line	:	1158 26TH ST # 138
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4621
Country	:	US
Telephone Number	:	310-804-1533
Fax Number	:

Provider Business Practice Location Address
First Line	:	1158 26TH ST # 138
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4621
Country	:	US
Telephone Number	:	310-804-1533
Fax Number	:

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	04/29/2010

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