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NPI Code Detail

MEDICARE: MRS. STELLA OBLATH MFT

MEDICARE:  MRS. STELLA  OBLATH  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 33518CA

General Provider Information

NPI Number : 1417152117
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STELLA OBLATH MFT
Provider Business Mailing Address
First Line : 24295 BRIDLE TRAIL RD
Second Line :
City : HIDDEN HILLS
State : CA
Zip : 91302-1176
Country : US
Telephone Number : 818-710-9687
Fax Number :
Provider Business Practice Location Address
First Line : 24295 BRIDLE TRAIL RD
Second Line :
City : HIDDEN HILLS
State : CA
Zip : 91302-1176
Country : US
Telephone Number : 818-710-9687
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. STELLA OBLATH MFT” Practice Location

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