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General NPI Number Information
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NPI Number | 1942468442
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Entity Type | Individual
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Provider Name | JEANNE A. MALTBY M. F. T.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 4713 1ST ST STE 250
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City | PLEASANTON
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State | CA
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Zip | 94566-7378
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Country | US
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Telephone | 925-895-5873
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Fax |
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Provider Business Mailing Address
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Address Line | 3494 BLAKEMORE CT
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City | PLEASANTON
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State | CA
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Zip | 94588-3512
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Country | US
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Telephone |
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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 20919
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License Number State | CA
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