=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225320187
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ZOE BECKER MA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2011
-----------------------------------------------------
Last Update Date | 05/11/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 131 BROMPTON AVE
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94131-3205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-748-2729
-----------------------------------------------------
Fax | 415-333-3526
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 131 BROMPTON AVE
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94131-3205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-748-2729
-----------------------------------------------------
Fax | 415-333-3526
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFT22703
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------