MEDICARE: JANIE LYNETTE MORTON CCDC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C101	OTHER	CA	C101

General Provider Information

NPI Number	:	1689858375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANIE LYNETTE MORTON CCDC

Provider Business Mailing Address
First Line	:	11900 SOUTH AVALON BLVD SUITE 200
Second Line	:	1
City	:	LOS ANGELES
State	:	CA
Zip	:	90061
Country	:	US
Telephone Number	:	323-242-0500
Fax Number	:	323-242-0600

Provider Business Practice Location Address
First Line	:	11900 AVALON BLVD STE 200
Second Line	:	1
City	:	LOS ANGELES
State	:	CA
Zip	:	90061-2867
Country	:	US
Telephone Number	:	323-242-0500
Fax Number	:	323-242-0600

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

Provider Enumeration Date	:	12/18/2007
Last Update Date	:	09/30/2015

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