MEDICARE: SYDNEY ASHE 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	AMFT146664	CA

General Provider Information

NPI Number	:	1881433001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY ASHE MFT

Provider Business Mailing Address
First Line	:	150 N BERENDO ST APT 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4887
Country	:	US
Telephone Number	:	513-257-3004
Fax Number	:

Provider Business Practice Location Address
First Line	:	553 N MARIPOSA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-2846
Country	:	US
Telephone Number	:	424-257-0966
Fax Number	:

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

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	05/20/2024

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Directions to “ SYDNEY ASHE MFT” Practice Location

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