1063523447 NPI number — MS. JUDITH SCANLON PAPPOFF LMFT

Table of content: MS. JUDITH SCANLON PAPPOFF LMFT (NPI 1063523447)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063523447 NPI number — MS. JUDITH SCANLON PAPPOFF LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAPPOFF
Provider First Name:
JUDITH
Provider Middle Name:
SCANLON
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PAPPOFF
Provider Other First Name:
JUDY
Provider Other Middle Name:
A.S.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMFT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1063523447
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17612 BEACH BLVD
Provider Second Line Business Mailing Address:
3B
Provider Business Mailing Address City Name:
HUNTINGTON BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92647-6873
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-843-2621
Provider Business Mailing Address Fax Number:
714-843-2621

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17612 BEACH BLVD
Provider Second Line Business Practice Location Address:
3B
Provider Business Practice Location Address City Name:
HUNTINGTON BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92647-6873
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-843-2621
Provider Business Practice Location Address Fax Number:
714-843-2621
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC22399 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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