MEDICARE: PAIGE CHRISTINE CLINE AMFT, MS

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	107378	CA

General Provider Information

NPI Number	:	1730738253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE CHRISTINE CLINE AMFT, MS

Provider Business Mailing Address
First Line	:	319 E PALM DR STE E
Second Line	:
City	:	PLACENTIA
State	:	CA
Zip	:	92870-3238
Country	:	US
Telephone Number	:	562-888-0768
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 E PALM DR STE E
Second Line	:
City	:	PLACENTIA
State	:	CA
Zip	:	92870-3238
Country	:	US
Telephone Number	:	562-888-0768
Fax Number	:

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

Provider Enumeration Date	:	09/06/2019
Last Update Date	:	09/06/2019

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