MEDICARE: MS. ANA ADAL MA

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	47420	CA

General Provider Information

NPI Number	:	1639295678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANA ADAL MA

Provider Business Mailing Address
First Line	:	1231 S ALFRED ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-2534
Country	:	US
Telephone Number	:	323-244-9613
Fax Number	:

Provider Business Practice Location Address
First Line	:	11600 WASHINGTON PL STE 202E
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-5068
Country	:	US
Telephone Number	:	323-244-9613
Fax Number	:

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	10/19/2018

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