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NPI Code Detail

MEDICARE: BONNIE FELDMAN MFT

MEDICARE: BONNIE FELDMAN 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 45325CA

General Provider Information

NPI Number : 1437559259
Entity Type Code : Organization
Provider Name (Legal Business Name) : BONNIE FELDMAN MFT
Provider Business Mailing Address
First Line : 1625 N LAUREL AVE APT 11
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-2519
Country : US
Telephone Number : 310-351-3474
Fax Number : 323-965-0444
Provider Business Practice Location Address
First Line : 5675 W OLYMPIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90036-4712
Country : US
Telephone Number : 323-965-1365
Fax Number : 323-965-0444
Authorized Official
Title or Position : LICENSED MARRIAGE & FAMILY THERAPIS
Name : MS. BONIE J FELDMAN
Credential : MFT
Telephone Number : 310-351-3474
Provider Enumeration Date : 08/28/2014
Last Update Date : 08/28/2014

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Directions to “BONNIE FELDMAN MFT ” Practice Location

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