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General NPI Number Information
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NPI Number | 1376882381
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Entity Type | Individual
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Provider Name | JONATHAN HILLEL FOX LMFT
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Gender | Male
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Dates
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Enumeration Date | 02/11/2013
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 492 EAST 13TH AVE STE 3
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City | EUGENE
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State | OR
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Zip | 97401
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Country | US
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Telephone | 458-215-1454
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 WILLAMETTE STREET STE 301 #234
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City | EUGENE
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State | OR
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Zip | 97401-4593
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Country | US
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Telephone | 707-782-2857
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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 | 90115
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License Number State | CA
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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 | T2211
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License Number State | OR
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