MEDICARE: MS. PAMELA MCNEILL BADGER M.S., M.F.T.

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	MFC 18715	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689711913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA MCNEILL BADGER M.S., M.F.T.

Provider Business Mailing Address
First Line	:	9105 AVOCADO ST
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-3303
Country	:	US
Telephone Number	:	619-589-1456
Fax Number	:

Provider Business Practice Location Address
First Line	:	3340 KEMPER ST
Second Line	:	STE 105
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4906
Country	:	US
Telephone Number	:	619-523-3812
Fax Number	:

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	12/11/2015

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