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NPI Code Detail

MEDICARE: AMY SQUIRES LMFT

MEDICARE: AMY SQUIRES 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 Therapist144673CA

General Provider Information

NPI Number : 1932948007
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY SQUIRES LMFT
Provider Business Mailing Address
First Line : 1231 YOSEMITE DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90041-2432
Country : US
Telephone Number : 718-496-3679
Fax Number :
Provider Business Practice Location Address
First Line : 200 E DEL MAR BLVD STE 160
Second Line :
City : PASADENA
State : CA
Zip : 91105-2507
Country : US
Telephone Number : 718-496-3679
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 “ AMY SQUIRES LMFT” Practice Location

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