MEDICARE: JASON ESSWEIN LMFT

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	MFC41 644	CA

General Provider Information

NPI Number	:	1699948364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON ESSWEIN LMFT

Provider Business Mailing Address
First Line	:	6698 DORENE PL
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95120-5430
Country	:	US
Telephone Number	:	408-230-7168
Fax Number	:

Provider Business Practice Location Address
First Line	:	1936 CAMDEN AVE STE 9
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2845
Country	:	US
Telephone Number	:	408-975-2982
Fax Number	:

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

Provider Enumeration Date	:	04/02/2008
Last Update Date	:	04/02/2008

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Directions to “ JASON ESSWEIN LMFT” Practice Location

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