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General NPI Number Information
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NPI Number | 1568072908
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Entity Type | Individual
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Provider Name | EMMA MEFOM LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 3840 HOMESTEAD RD
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City | SANTA CLARA
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State | CA
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Zip | 95051-4542
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Country | US
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Telephone | 408-851-4938
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Fax |
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Provider Business Mailing Address
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Address Line | 300 PASTEUR DR RM HC 029
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City | STANFORD
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State | CA
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Zip | 94305-2200
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 94605
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License Number State | CA
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