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NPI Code Detail

MEDICARE: SHELLIE DANIELLE FURUTA MA, MFT

MEDICARE: SHELLIE DANIELLE FURUTA MA, 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
1106H00000XMarriage & Family TherapistMFC 48334CA

General Provider Information

NPI Number : 1386894343
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLIE DANIELLE FURUTA MA, MFT
Provider Business Mailing Address
First Line : 1094 CUDAHY PL STE 314
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3924
Country : US
Telephone Number : 619-275-0822
Fax Number : 619-275-5069
Provider Business Practice Location Address
First Line : 1094 CUDAHY PL STE 314
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3924
Country : US
Telephone Number : 619-275-0822
Fax Number : 619-275-5069
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2008
Last Update Date : 08/14/2014

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