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General NPI Number Information
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NPI Number | 1043588643
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Entity Type | Individual
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Provider Name | IARA MARIA CAMPOS-DAVIDS MFT
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Gender | Female
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Dates
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Enumeration Date | 12/09/2011
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 2086 COMMERCE AVE
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City | CONCORD
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State | CA
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Zip | 94520-4902
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Country | US
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Telephone | 925-260-0318
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Fax |
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Provider Business Mailing Address
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Address Line | 2528 WASHINGTON WAY
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City | ALAMEDA
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State | CA
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Zip | 94501-5326
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Country | US
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Telephone | 510-520-5465
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 78179
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License Number State | CA
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