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NPI Code Detail

MEDICARE: MS. KARLYN RENE FARRIS BBS

MEDICARE: MS. KARLYN RENE FARRIS BBS
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
1101YM0800XMental Health Counselor105786CA

General Provider Information

NPI Number : 1952025876
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KARLYN RENE FARRIS BBS
Provider Business Mailing Address
First Line : 2034 COTNER AVE STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-5664
Country : US
Telephone Number : 818-335-5200
Fax Number : 310-889-0440
Provider Business Practice Location Address
First Line : 2034 COTNER AVE STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-5664
Country : US
Telephone Number : 818-335-5200
Fax Number : 310-889-0440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2022
Last Update Date : 10/04/2022

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