MEDICARE: MS. SAUNDRA JEAN EDWARDS MFT

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	MFT 36706	CA

General Provider Information

NPI Number	:	1578636643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SAUNDRA JEAN EDWARDS MFT

Provider Business Mailing Address
First Line	:	15000 DOWNEY AVE
Second Line	:	UNIT 268
City	:	PARAMOUNT
State	:	CA
Zip	:	90723-4597
Country	:	US
Telephone Number	:	562-531-6484
Fax Number	:

Provider Business Practice Location Address
First Line	:	5777 W CENTURY BLVD
Second Line	:	SUITE 910
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5600
Country	:	US
Telephone Number	:	323-365-1856
Fax Number	:	323-586-3988

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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