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NPI Code Detail

MEDICARE: ELLEN GECHT MFT

MEDICARE: ELLEN GECHT 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
1106H00000XMarriage & Family TherapistMFC20900CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MFC20900OTHERCALICENSE NUMBER

General Provider Information

NPI Number : 1972716264
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN GECHT MFT
Provider Business Mailing Address
First Line : 30100 CROWN VALLEY PKWY STE 17
Second Line :
City : LAGUNA NIGUEL
State : CA
Zip : 92677-2041
Country : US
Telephone Number : 949-831-0939
Fax Number : 949-831-6123
Provider Business Practice Location Address
First Line : 30100 CROWN VALLEY PKWY STE 17
Second Line :
City : LAGUNA NIGUEL
State : CA
Zip : 92677-2041
Country : US
Telephone Number : 949-831-0939
Fax Number : 949-831-6123
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2007
Last Update Date : 07/08/2007

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Directions to “ ELLEN GECHT MFT” Practice Location

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