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NPI Code Detail

MEDICARE: MR. JONATHAN LYNCH MA, LMFT

MEDICARE: MR. JONATHAN LYNCH MA, 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
1106H00000XMarriage & Family TherapistMFT43101CA

General Provider Information

NPI Number : 1477643849
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JONATHAN LYNCH MA, LMFT
Provider Business Mailing Address
First Line : 1224 NORTH VINE STREET
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027
Country : US
Telephone Number : 323-769-2181
Fax Number :
Provider Business Practice Location Address
First Line : 1224 VINE ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90038-1612
Country : US
Telephone Number : 323-769-2181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 07/08/2007

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