MEDICARE: ABIGAIL MOLINA MA

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	ASW61570	CA

General Provider Information

NPI Number	:	1518374917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL MOLINA MA

Provider Business Mailing Address
First Line	:	713 S PACIFIC COAST HWY STE C
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-4233
Country	:	US
Telephone Number	:	424-258-0162
Fax Number	:

Provider Business Practice Location Address
First Line	:	713 S PACIFIC COAST HWY STE C
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-4233
Country	:	US
Telephone Number	:	424-258-0162
Fax Number	:

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

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	10/01/2021

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