MEDICARE: MS. BARBARA LYNN BREITMAN 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
1	106H00000X	Marriage & Family Therapist	MFC31835	CA

General Provider Information

NPI Number	:	1548360225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA LYNN BREITMAN LMFT

Provider Business Mailing Address
First Line	:	1262 S BARRINGTON AVE
Second Line	:	UNIT 308
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1656
Country	:	US
Telephone Number	:	310-477-3834
Fax Number	:

Provider Business Practice Location Address
First Line	:	11340 W OLYMPIC BLVD
Second Line	:	SUITE 310
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1608
Country	:	US
Telephone Number	:	310-477-3834
Fax Number	:

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

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	07/08/2007

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