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NPI Code Detail

MEDICARE: MR. JAY MOSOFF LMFT

MEDICARE: MR. JAY MOSOFF 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 TherapistMFC35300CA

General Provider Information

NPI Number : 1639206279
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAY MOSOFF LMFT
Provider Business Mailing Address
First Line : 3417 W 82ND PL
Second Line :
City : INGLEWOOD
State : CA
Zip : 90305-1602
Country : US
Telephone Number : 323-759-4808
Fax Number :
Provider Business Practice Location Address
First Line : 5849 CROCKER ST UNIT L
Second Line :
City : LOS ANGELES
State : CA
Zip : 90003-1311
Country : US
Telephone Number : 323-234-4445
Fax Number : 323-234-4477
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 05/16/2018

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