MEDICARE: DR. ANNE MARIE A BLOCH PHD

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
1	103TC0700X	Clinical Psychologist	PSY3890	CA

General Provider Information

NPI Number	:	1154495638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE MARIE A BLOCH PHD

Provider Business Mailing Address
First Line	:	3663 SACRAMENTO ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1709
Country	:	US
Telephone Number	:	415-931-0500
Fax Number	:	510-547-3071

Provider Business Practice Location Address
First Line	:	3663 SACRAMENTO ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1709
Country	:	US
Telephone Number	:	415-931-0500
Fax Number	:	510-547-3071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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