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General NPI Number Information
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NPI Number | 1629101464
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Entity Type | Individual
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Provider Name | MARY ANN COKER MFT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 20632 REDWOOD RD SUITE D
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5602
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Country | US
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Telephone | 510-748-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 1368 EASTSHORE DR
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City | ALAMEDA
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State | CA
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Zip | 94501-3114
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Country | US
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Telephone | 510-719-6852
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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 | MFT 30258
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License Number State | CA
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