MEDICARE: CHRISTINA ELENA OJEDA LMFT 103522

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
2	106H00000X	Marriage & Family Therapist	103522	CA

General Provider Information

NPI Number	:	1487060182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ELENA OJEDA LMFT 103522

Provider Business Mailing Address
First Line	:	108 WEST VICTORIA STREET
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-6733
Country	:	US
Telephone Number	:	310-715-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 WEST VICTORIA STREET
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-6733
Country	:	US
Telephone Number	:	310-715-2020
Fax Number	:

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

Provider Enumeration Date	:	07/02/2014
Last Update Date	:	03/17/2018

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