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NPI Code Detail

MEDICARE: MEGAN ELIZABETH CREEDON RBT

MEDICARE: MEGAN ELIZABETH CREEDON RBT
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
1225400000XRehabilitation Practitioner
2390200000XStudent in an Organized Health Care Education/Training Program
31041C0700XClinical Social Worker132135CA

General Provider Information

NPI Number : 1750884359
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN ELIZABETH CREEDON RBT
Provider Business Mailing Address
First Line : 4601 S BROADWAY
Second Line :
City : LOS ANGELES
State : CA
Zip : 90037-2729
Country : US
Telephone Number : 323-234-4445
Fax Number :
Provider Business Practice Location Address
First Line : 4601 S BROADWAY
Second Line :
City : LOS ANGELES
State : CA
Zip : 90037-2729
Country : US
Telephone Number : 323-234-4445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2018
Last Update Date : 07/25/2025

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Directions to “ MEGAN ELIZABETH CREEDON RBT” Practice Location

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