MEDICARE: IRIT ALMOG MA, 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	49691	CA

General Provider Information

NPI Number	:	1588905574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRIT ALMOG MA, LMFT

Provider Business Mailing Address
First Line	:	5308 DERRY AVE STE L201
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-4517
Country	:	US
Telephone Number	:	818-422-1088
Fax Number	:

Provider Business Practice Location Address
First Line	:	5308 DERRY AVE STE L201
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301
Country	:	US
Telephone Number	:	818-422-1088
Fax Number	:

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

Provider Enumeration Date	:	03/15/2013
Last Update Date	:	08/02/2018

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