MEDICARE: DR. MICHELE A FELIX PHD

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	103TC0700X	Clinical Psychologist	PSY 15534	CA

General Provider Information

NPI Number	:	1568497808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE A FELIX PHD

Provider Business Mailing Address
First Line	:	PO BOX 666
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-0666
Country	:	US
Telephone Number	:	562-434-7606
Fax Number	:	310-316-9444

Provider Business Practice Location Address
First Line	:	5855 E NAPLES PLZ
Second Line	:	SUITE 317
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5060
Country	:	US
Telephone Number	:	562-434-7606
Fax Number	:	310-316-9444

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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