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NPI Code Detail

MEDICARE: LYNETTA LOUISE HALE AMFT

MEDICARE: LYNETTA LOUISE HALE AMFT
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
1390200000XStudent in an Organized Health Care Education/Training Program
2106H00000XMarriage & Family Therapist154477CA
3106H00000XMarriage & Family Therapist
4225400000XRehabilitation Practitioner

Other Identifiers

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

General Provider Information

NPI Number : 1801920285
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNETTA LOUISE HALE AMFT
Provider Business Mailing Address
First Line : 223 E ROWLAND ST
Second Line :
City : COVINA
State : CA
Zip : 91723-3147
Country : US
Telephone Number : 626-332-3145
Fax Number :
Provider Business Practice Location Address
First Line : 223 E ROWLAND ST
Second Line :
City : COVINA
State : CA
Zip : 91723-3147
Country : US
Telephone Number : 626-332-3145
Fax Number : 626-974-4164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 04/10/2025

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