MEDICARE: JESS MARON

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	225700000X	Massage Therapist	37980	CA

General Provider Information

NPI Number	:	1942602271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESS MARON

Provider Business Mailing Address
First Line	:	1533 SHATTUCK AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94709-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1533 SHATTUCK AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94709-1516
Country	:	US
Telephone Number	:	415-683-0532
Fax Number	:

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

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/17/2015

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Directions to “ JESS MARON ” Practice Location

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