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NPI Code Detail

MEDICARE: ANTONETTE MARIE BELLOWS MFT

MEDICARE: ANTONETTE MARIE BELLOWS MFT
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
1101Y00000XCounselor
2106H00000XMarriage & Family Therapist162428CA

General Provider Information

NPI Number : 1689986630
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTONETTE MARIE BELLOWS MFT
Provider Business Mailing Address
First Line : 1702 S MAYFLOWER AVE APT O
Second Line :
City : MONROVIA
State : CA
Zip : 91016-4551
Country : US
Telephone Number : 310-857-0023
Fax Number :
Provider Business Practice Location Address
First Line : 1680 N FAIR OAKS AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-1642
Country : US
Telephone Number : 626-798-0884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2010
Last Update Date : 03/23/2026

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