MEDICARE: MRS. ROSA MARGARITA ORTIZ FEBLES MA, MFTI

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	106H00000X	Marriage & Family Therapist	IMF57316	CA

General Provider Information

NPI Number	:	1508092651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSA MARGARITA ORTIZ FEBLES MA, MFTI

Provider Business Mailing Address
First Line	:	7024 SEVILLE AVE STE D
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4969
Country	:	US
Telephone Number	:	323-588-9600
Fax Number	:	323-588-9696

Provider Business Practice Location Address
First Line	:	7024 SEVILLE AVE STE D
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4969
Country	:	US
Telephone Number	:	323-588-9600
Fax Number	:	323-588-9696

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

Provider Enumeration Date	:	06/03/2009
Last Update Date	:	06/03/2009

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