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General NPI Number Information
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NPI Number | 1881419091
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Entity Type | Organization
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Legal Business Name | JUNIPER & JADE PSYCHOTHERAPY INC.
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 175 N REDWOOD DR STE 225
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1972
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Country | US
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Telephone | 415-234-3774
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Fax |
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Provider Business Mailing Address
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Address Line | 175 N REDWOOD DR STE 225
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1972
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Country | US
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Telephone | 415-234-3774
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | MARIA T ARIETA
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Credential | PSYD
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Telephone | 415-234-3774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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