MEDICARE: TIFFANY LIND JUMP MFT

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	LMFT 43966	CA

General Provider Information

NPI Number	:	1346307014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY LIND JUMP MFT

Provider Business Mailing Address
First Line	:	6060 N PARAMOUNT BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-3711
Country	:	US
Telephone Number	:	562-630-8672
Fax Number	:	562-529-2463

Provider Business Practice Location Address
First Line	:	6060 N PARAMOUNT BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-3711
Country	:	US
Telephone Number	:	562-630-8672
Fax Number	:	562-529-2463

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

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	11/24/2021

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