Provider Demographics
NPI:1568497808
Name:FELIX, MICHELE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:A
Last Name:FELIX
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 666
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-0666
Mailing Address - Country:US
Mailing Address - Phone:562-434-7606
Mailing Address - Fax:310-316-9444
Practice Address - Street 1:5855 E NAPLES PLZ
Practice Address - Street 2:SUITE 317
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5060
Practice Address - Country:US
Practice Address - Phone:562-434-7606
Practice Address - Fax:310-316-9444
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 15534103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical