MEDICARE: REBECCA LEE ZAINO M.A., L.M.F.T.

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 49080	CA

General Provider Information

NPI Number	:	1306184882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA LEE ZAINO M.A., L.M.F.T.

Provider Business Mailing Address
First Line	:	22792 CENTRE DR
Second Line	:	SUITE 101
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-6304
Country	:	US
Telephone Number	:	949-464-8834
Fax Number	:

Provider Business Practice Location Address
First Line	:	22792 CENTRE DR
Second Line	:	SUITE 101
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-6304
Country	:	US
Telephone Number	:	949-464-8834
Fax Number	:

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

Provider Enumeration Date	:	01/17/2013
Last Update Date	:	01/17/2013

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