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NPI Code Detail

MEDICARE: MS. DANETTE J CANTRELL LMFT

MEDICARE: MS. DANETTE J CANTRELL 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 Therapist

General Provider Information

NPI Number : 1689873309
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DANETTE J CANTRELL LMFT
Provider Business Mailing Address
First Line : 10929 SOUTH ST STE 208B
Second Line :
City : CERRITOS
State : CA
Zip : 90703-5391
Country : US
Telephone Number : 562-924-5526
Fax Number : 562-692-0380
Provider Business Practice Location Address
First Line : 10929 SOUTH ST STE 208B
Second Line :
City : CERRITOS
State : CA
Zip : 90703-5391
Country : US
Telephone Number : 562-924-5526
Fax Number : 562-692-0380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2007
Last Update Date : 04/21/2022

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