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General NPI Number Information
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NPI Number | 1932459435
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Entity Type | Individual
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Provider Name | MS. JUNE MARIE THREADGOULD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 2625 ZANKER ROAD
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City | SAN JOSE
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State | CA
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Zip | 95134-2130
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Country | US
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Telephone | 408-325-5120
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Fax | 408-944-9114
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Provider Business Mailing Address
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Address Line | 620 WILLOWGATE STREET UNIT 6
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94043-4881
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Country | US
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Telephone | 650-210-6653
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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 |
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License Number State |
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