MEDICARE: ANN MCDONALD RICE MFT

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	106H00000X	Marriage & Family Therapist	MFC 16465	CA

General Provider Information

NPI Number	:	1629066063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN MCDONALD RICE MFT

Provider Business Mailing Address
First Line	:	123 CLELAND AVE
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95030-7057
Country	:	US
Telephone Number	:	408-354-3238
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 SAMARITAN DR
Second Line	:	SUITE E
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4104
Country	:	US
Telephone Number	:	408-354-3238
Fax Number	:	408-358-9856

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	07/08/2007

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