Healthcare Provider Details

I. General information

NPI: 1396376612
Provider Name (Legal Business Name): JESSICA GIOIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 01/27/2020
Certification Date: 01/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 POLK ST
SAN FRANCISCO CA
94109-7813
US

IV. Provider business mailing address

1518 BROADWAY APT A
ALAMEDA CA
94501-3071
US

V. Phone/Fax

Practice location:
  • Phone: 415-554-8444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: