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General NPI Number Information
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NPI Number | 1871099010
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Entity Type | Organization
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Legal Business Name | JOANNE DAVIS MARRIAGE AND FAMILY THERAPIST INC
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Dates
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Enumeration Date | 04/05/2018
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 582 MARKET ST STE 415
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-5324
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Country | US
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Telephone | 510-295-3270
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Fax |
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Provider Business Mailing Address
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Address Line | 2833 BUENA VISTA WAY # A
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City | BERKELEY
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State | CA
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Zip | 94708-2015
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Country | US
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Telephone | 510-295-3270
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOANNE HOPE DAVIS
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Credential | MFT
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Telephone | 510-295-3279
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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 | 40116
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License Number State | CA
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