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NPI Code Detail

MEDICARE: COLLEEN JEFFERS

MEDICARE: COLLEEN JEFFERS
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) Counselor

General Provider Information

NPI Number : 1881739134
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN JEFFERS
Provider Business Mailing Address
First Line : 2637 35TH AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94619-1001
Country : US
Telephone Number : 510-534-1773
Fax Number :
Provider Business Practice Location Address
First Line : 1601 QUESADA AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94124-2334
Country : US
Telephone Number : 415-822-5977
Fax Number : 415-822-5943
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 07/08/2007

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Directions to “ COLLEEN JEFFERS ” Practice Location

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