MEDICARE: CARMELA J GIARDINA MFT INTERN

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	IMF61721	CA
2	106H00000X	Marriage & Family Therapist	IMF 61721	CA

General Provider Information

NPI Number	:	1427372549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMELA J GIARDINA MFT INTERN

Provider Business Mailing Address
First Line	:	1200 WILSHIRE BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-1919
Country	:	US
Telephone Number	:	213-416-1164
Fax Number	:	213-481-7147

Provider Business Practice Location Address
First Line	:	1200 WILSHIRE BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-1919
Country	:	US
Telephone Number	:	213-416-1164
Fax Number	:	213-481-7147

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

Provider Enumeration Date	:	03/18/2010
Last Update Date	:	04/12/2022

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