Healthcare Provider Details

I. General information

NPI: 1487327300
Provider Name (Legal Business Name): MAGGIE JO BARTELS HOULE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. MAGGIE JO BARTELS HOULE

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ALLERTON ST
REDWOOD CITY CA
94063-1519
US

IV. Provider business mailing address

500 ALLERTON ST
REDWOOD CITY CA
94063-1519
US

V. Phone/Fax

Practice location:
  • Phone: 650-599-9955
  • Fax:
Mailing address:
  • Phone: 650-599-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number410038DN
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: