MEDICARE: MARCI DADD 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	MFC36994	CA

General Provider Information

NPI Number	:	1396857082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCI DADD LMFT

Provider Business Mailing Address
First Line	:	31897 DEL OBISPO ST STE 250
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-3243
Country	:	US
Telephone Number	:	949-329-2522
Fax Number	:	949-276-7911

Provider Business Practice Location Address
First Line	:	31897 DEL OBISPO ST STE 250
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-3243
Country	:	US
Telephone Number	:	949-329-2522
Fax Number	:	949-276-7911

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	06/22/2019

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