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NPI Code Detail

MEDICARE: VICKI COFFMAN LMFT

MEDICARE: VICKI COFFMAN 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
1106H00000XMarriage & Family Therapist83503CA
2106H00000XMarriage & Family Therapist0717002007VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578802146
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI COFFMAN LMFT
Provider Business Mailing Address
First Line : 29970 TECHNOLOGY DR STE 212
Second Line :
City : MURRIETA
State : CA
Zip : 92563-2649
Country : US
Telephone Number : 951-900-4414
Fax Number : 951-880-0817
Provider Business Practice Location Address
First Line : 29970 TECHNOLOGY DR STE 212
Second Line :
City : MURRIETA
State : CA
Zip : 92563-2649
Country : US
Telephone Number : 951-900-4414
Fax Number : 951-880-0817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2013
Last Update Date : 12/08/2024

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Directions to “ VICKI COFFMAN LMFT” Practice Location

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