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NPI Code Detail

MEDICARE: ERICA DENISE LODGEN MA, LMFT

MEDICARE: ERICA DENISE LODGEN MA, LMFT
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 TherapistMFT33650CA

General Provider Information

NPI Number : 1912042847
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA DENISE LODGEN MA, LMFT
Provider Business Mailing Address
First Line : 3601 CALLE TECATE STE 201
Second Line :
City : CAMARILLO
State : CA
Zip : 93012-5056
Country : US
Telephone Number : 805-748-7653
Fax Number :
Provider Business Practice Location Address
First Line : 3601 CALLE TECATE STE 201
Second Line :
City : CAMARILLO
State : CA
Zip : 93012-5056
Country : US
Telephone Number : 805-748-7653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 06/20/2024

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