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General NPI Number Information
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NPI Number | 1053782862
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Entity Type | Individual
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Provider Name | JACQUELINE BOYD LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 2648 INTERNATIONAL BLVD STE 115 PMB 43
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City | OAKLAND
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State | CA
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Zip | 94601
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Country | US
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Telephone | 510-542-9212
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Fax |
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Provider Business Mailing Address
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Address Line | 2648 INTERNATIONAL BLVD STE 115 PMB 43
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City | OAKLAND
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State | CA
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Zip | 94601
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Country | US
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Telephone | 510-542-9212
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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 | 3530
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 200001333
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 115424
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License Number State | CA
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