=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548433386
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. MARY LOUISE SAAVEDRA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2008
-----------------------------------------------------
Last Update Date | 04/11/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 433 TURK ST
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94102-3329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-928-7800
-----------------------------------------------------
Fax | 415-928-3710
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 614 CAPITOL ST #3
-----------------------------------------------------
City | VALLEJO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-648-2795
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------