Mini Fanega, M.A

Individual provider Active NPI Marriage & Family Therapist · Rolling Hills Estates, CA

NPI 1508068248 · NPPES record last updated Sep 26, 2022

Key facts

NPI
1508068248
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC 50567 (CA)
Practice address
916 Silver Spur Rd Ste 308
Rolling Hills Estates, CA 90274-3828
Phone
(424) 571-3806
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC 50567CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 50567 CA Yes

Addresses

Primary practice location

916 Silver Spur Rd Ste 308
Rolling Hills Estates, CA 90274-3828

Mailing address

916 Silver Spur Rd Ste 308
Rolling Hills Estates, CA 90274-3828
Phone (424) 571-3806

Other practice location 1

2716 S Vermont Ave Ste 9
Los Angeles, CA 90007-2594
Phone (424) 571-3806

Other providers in Rolling Hills Estates, CA

All providers in Rolling Hills Estates, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.