Healthcare Provider Details

I. General information

NPI: 1346340726
Provider Name (Legal Business Name): VICTORIA W JEFFERS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 WINDING BROOK ROAD
CALIFON NJ
07830
US

IV. Provider business mailing address

670 WINDING BROOK ROAD
CALIFON NJ
07830
US

V. Phone/Fax

Practice location:
  • Phone: 908-832-6683
  • Fax: 908-832-6679
Mailing address:
  • Phone: 908-832-6679
  • Fax: 908-832-6679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberSIO1861
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: