MEDICARE: BEATRIZ GUTIERREZ- ESCALANTE 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	LMFT120448	CA

General Provider Information

NPI Number	:	1346419298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRIZ GUTIERREZ- ESCALANTE LMFT

Provider Business Mailing Address
First Line	:	1605 W OLYMPIC BLVD STE 1035
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3864
Country	:	US
Telephone Number	:	818-458-4950
Fax Number	:	323-372-3712

Provider Business Practice Location Address
First Line	:	1605 W OLYMPIC BLVD STE 1035
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3864
Country	:	US
Telephone Number	:	818-458-4950
Fax Number	:	323-372-3712

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

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	12/01/2021

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