MEDICARE: EARLY START PRESCHOOLS

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	251S00000X	Community/Behavioral Health Agency	MFC48568	CA

General Provider Information

NPI Number	:	1912242413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EARLY START PRESCHOOLS

Provider Business Mailing Address
First Line	:	2505 LINCOLN BLVD
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-3817
Country	:	US
Telephone Number	:	310-452-5437
Fax Number	:	310-314-9933

Provider Business Practice Location Address
First Line	:	2505 LINCOLN BLVD
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-3817
Country	:	US
Telephone Number	:	310-452-5437
Fax Number	:	310-314-9933

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	MS. SHARON L LOWERY
Credential	:	M.A.
Telephone Number	:	310-452-5437

Provider Enumeration Date	:	12/10/2012
Last Update Date	:	12/10/2012

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Directions to “EARLY START PRESCHOOLS ” Practice Location

Language	Start Address	Practice Location

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