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NPI Code Detail

MEDICARE: JOHN MARK KANE

MEDICARE: JOHN MARK KANE
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
1106H00000XMarriage & Family Therapist134414CA

General Provider Information

NPI Number : 1376712174
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MARK KANE
Provider Business Mailing Address
First Line : 1700 EUREKA RD STE 155
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-7786
Country : US
Telephone Number : 408-461-9658
Fax Number :
Provider Business Practice Location Address
First Line : 1700 EUREKA RD STE 155
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-7786
Country : US
Telephone Number : 408-461-9658
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2008
Last Update Date : 04/18/2024

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Directions to “ JOHN MARK KANE ” Practice Location

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