MEDICARE: ALEXANDER RAINER FELDT 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	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist	102977	CA
3	106H00000X	Marriage & Family Therapist	122652	CA

General Provider Information

NPI Number	:	1356856645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER RAINER FELDT LMFT

Provider Business Mailing Address
First Line	:	1224 E KATELLA AVE STE 209
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92867-5049
Country	:	US
Telephone Number	:	949-285-9118
Fax Number	:

Provider Business Practice Location Address
First Line	:	1224 E KATELLA AVE STE 209
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92867-5049
Country	:	US
Telephone Number	:	562-248-6672
Fax Number	:

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

Provider Enumeration Date	:	12/07/2017
Last Update Date	:	08/05/2022

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