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NPI Code Detail

MEDICARE: MEHERET FIKRE-SELLASSIE

MEDICARE:   MEHERET  FIKRE-SELLASSIE
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 : 1720413040
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEHERET FIKRE-SELLASSIE
Provider Business Mailing Address
First Line : 320 LEE ST APT 1001
Second Line :
City : OAKLAND
State : CA
Zip : 94610-4325
Country : US
Telephone Number : 510-219-6916
Fax Number :
Provider Business Practice Location Address
First Line : 320 LEE ST APT 1001
Second Line :
City : OAKLAND
State : CA
Zip : 94610-4325
Country : US
Telephone Number : 510-219-6916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2013
Last Update Date : 09/05/2013

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Directions to “ MEHERET FIKRE-SELLASSIE ” Practice Location

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