MEDICARE: MRS. PAM E LUSCHEI 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
1	106H00000X	Marriage & Family Therapist	MFT 37185	CA

General Provider Information

NPI Number	:	1730190414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAM E LUSCHEI MFT

Provider Business Mailing Address
First Line	:	7777 ALVARADO RD
Second Line	:	SUITE 273
City	:	LA MESA
State	:	CA
Zip	:	91941-3616
Country	:	US
Telephone Number	:	619-460-8500
Fax Number	:	619-460-8502

Provider Business Practice Location Address
First Line	:	7777 ALVARADO RD
Second Line	:	SUITE 273
City	:	LA MESA
State	:	CA
Zip	:	91941-3616
Country	:	US
Telephone Number	:	619-460-8500
Fax Number	:	619-460-8502

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	01/12/2009

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