MEDICARE: DR. JENNIFER ELIZABETH BOYD PHD

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	103TC0700X	Clinical Psychologist	PSY17753	CA

General Provider Information

NPI Number	:	1912940818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER ELIZABETH BOYD PHD

Provider Business Mailing Address
First Line	:	4150 CLEMENT ST
Second Line	:	PSYCHIATRY (116A)
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-1545
Country	:	US
Telephone Number	:	415-221-4810
Fax Number	:	415-668-7503

Provider Business Practice Location Address
First Line	:	1801 BUSH ST
Second Line	:	SUITE 210
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-5239
Country	:	US
Telephone Number	:	415-572-5838
Fax Number	:	415-668-7503

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	07/08/2007

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