| Penny Lane Centers | |
|
43520 Division St Lancaster CA 93535-4089 | |
| (661) 266-4783 | |
| (661) 266-1210 |
| Full Name | Penny Lane Centers |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 43520 Division St, Lancaster, California |
| Authorized Official Name and Position | Mary M Fallie (FACILITATOR/AV) |
| Authorized Official Contact | 6612664783 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Penny Lane Centers 43520 Division St Lancaster CA 93535-4089 Ph: (661) 266-4783 | Penny Lane Centers 43520 Division St Lancaster CA 93535-4089 Ph: (661) 266-4783 |
| NPI Number | 1790144095 |
|---|---|
| Provider Enumeration Date | 02/15/2016 |
| Last Update Date | 06/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790144095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 88669 (California) | Primary |
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