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NPI Code Detail

MEDICARE: ALYESE LYNETTE WHITFIELD

MEDICARE: ALYESE LYNETTE WHITFIELD
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 Therapist111971CA
2101Y00000XCounselor

General Provider Information

NPI Number : 1619287067
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYESE LYNETTE WHITFIELD
Provider Business Mailing Address
First Line : PO BOX 997
Second Line :
City : MORENO VALLEY
State : CA
Zip : 92556-0997
Country : US
Telephone Number : 909-973-4251
Fax Number :
Provider Business Practice Location Address
First Line : 25910 ACERO STE 160
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-2777
Country : US
Telephone Number : 714-966-8650
Fax Number : 714-434-2675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2010
Last Update Date : 07/29/2022

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Directions to “ ALYESE LYNETTE WHITFIELD ” Practice Location

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