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General NPI Number Information
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NPI Number | 1588149298
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Entity Type | Individual
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Provider Name | TIMOTHY COLDIRON LMFT
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Gender | Male
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Dates
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Enumeration Date | 09/27/2018
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 19000 HOMESTEAD RD
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City | CUPERTINO
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State | CA
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Zip | 95014-0712
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Country | US
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Telephone | 408-366-4319
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Fax |
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Provider Business Mailing Address
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Address Line | 1172 CHIAPAS TER
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City | SAN JOSE
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State | CA
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Zip | 95126-1089
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Country | US
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Telephone | 408-582-4848
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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 | 109006
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License Number State | CA
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