MEDICARE: MS. MARIE JANET PADVEEN MFC

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	106H00000X	Marriage & Family Therapist	MFC33209	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1730157132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIE JANET PADVEEN MFC

Provider Business Mailing Address
First Line	:	2566 OVERLAND AVE
Second Line	:	500A
City	:	LOS ANGELES
State	:	CA
Zip	:	90064
Country	:	US
Telephone Number	:	310-588-0090
Fax Number	:	310-836-2312

Provider Business Practice Location Address
First Line	:	2566 OVERLAND AVE
Second Line	:	500A
City	:	LOS ANGELES
State	:	CA
Zip	:	90064
Country	:	US
Telephone Number	:	310-588-0090
Fax Number	:	310-836-2312

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

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	07/08/2007

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