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General NPI Number Information
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NPI Number | 1982824058
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Entity Type | Individual
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Provider Name | ANNE L JORGENSEN MFT
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Gender | Female
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 10/22/2018
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Provider Practice Location Address
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Address Line | 5851 BALBOA DR
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City | OAKLAND
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State | CA
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Zip | 94611-2316
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Country | US
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Telephone | 415-299-9185
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Fax |
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Provider Business Mailing Address
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Address Line | 2532 SANTA CLARA AVE
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City | ALAMEDA
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State | CA
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Zip | 94501-4634
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Country | US
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Telephone | 415-299-9185
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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 | MFT27273
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License Number State | CA
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