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NPI Code Detail

MEDICARE: JUDITH A. ERVICE LMFT

MEDICARE: JUDITH A. ERVICE 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 TherapistMFC32495CA

General Provider Information

NPI Number : 1588699128
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH A. ERVICE LMFT
Provider Business Mailing Address
First Line : 3707 3RD AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-4111
Country : US
Telephone Number : 619-294-9011
Fax Number : 619-542-0324
Provider Business Practice Location Address
First Line : 3707 3RD AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-4111
Country : US
Telephone Number : 619-294-9011
Fax Number : 619-542-0324
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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Directions to “ JUDITH A. ERVICE LMFT” Practice Location

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