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NPI Code Detail

MEDICARE: MS. ELLEN EDELMAN LMFT

MEDICARE:  MS. ELLEN  EDELMAN  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 TherapistMFT12175CA

Other Identifiers

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

General Provider Information

NPI Number : 1689720401
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELLEN EDELMAN LMFT
Provider Business Mailing Address
First Line : PO BOX 3171
Second Line :
City : DALY CITY
State : CA
Zip : 94015-0171
Country : US
Telephone Number : 650-994-7464
Fax Number : 650-994-7464
Provider Business Practice Location Address
First Line : 1475 HUNTINGTON AVE
Second Line : 201
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-5990
Country : US
Telephone Number : 650-994-7464
Fax Number : 650-994-7464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 07/09/2007

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Directions to “ MS. ELLEN EDELMAN LMFT” Practice Location

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