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NPI Code Detail

MEDICARE: MIKAYLA BRELYNN HARRIS

MEDICARE: MIKAYLA BRELYNN HARRIS
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
1106H00000XMarriage & Family Therapist157685CA

General Provider Information

NPI Number : 1811720592
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAYLA BRELYNN HARRIS
Provider Business Mailing Address
First Line : 400 CORPORATE POINTE STE 300
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-7620
Country : US
Telephone Number : 323-681-6770
Fax Number :
Provider Business Practice Location Address
First Line : 400 CORPORATE POINTE STE 300
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-7620
Country : US
Telephone Number : 323-681-6770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2024
Last Update Date : 12/08/2025

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Directions to “ MIKAYLA BRELYNN HARRIS ” Practice Location

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