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NPI Code Detail

MEDICARE: MRS. MELANIE JANE HOOVER CADC-CAS

MEDICARE: MRS. MELANIE JANE HOOVER CADC-CAS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor085884CA

General Provider Information

NPI Number : 1528457959
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELANIE JANE HOOVER CADC-CAS
Provider Business Mailing Address
First Line : 1477 LINCOLN AVE
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-2028
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1477 LINCOLN AVE
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-2028
Country : US
Telephone Number : 415-459-2395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2015
Last Update Date : 01/22/2015

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