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General NPI Number Information
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NPI Number | 1306852348
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Entity Type | Individual
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Provider Name | JANE COOPER MATIJASIC LCSW BCD
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 1303 JEFFERSON ST SUITE 600A
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City | NAPA
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State | CA
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Zip | 94559-2442
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Country | US
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Telephone | 707-257-1049
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Fax | 707-224-2894
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Provider Business Mailing Address
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Address Line | 1303 JEFFERSON ST SUITE 600A
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City | NAPA
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State | CA
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Zip | 94559-2442
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Country | US
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Telephone | 707-257-1049
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Fax | 707-224-2894
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS9140
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License Number State | CA
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