MEDICARE: MS. PICHA JINI WATKINS

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	174400000X	Specialist
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1225180862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PICHA JINI WATKINS

Provider Business Mailing Address
First Line	:	2275 ARLINGTON DR
Second Line	:	SENECA CENTER
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-1132
Country	:	US
Telephone Number	:	510-317-1444
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PARKMOOR AVE STE 115
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-3797
Country	:	US
Telephone Number	:	408-971-9822
Fax Number	:

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	06/02/2021

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