MEDICARE: MISS KATHRYN AIMEE REBECCA JAMES MFT 46494

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	46494	CA

General Provider Information

NPI Number	:	1043448616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KATHRYN AIMEE REBECCA JAMES MFT 46494

Provider Business Mailing Address
First Line	:	2141 PACIFIC AVE # 3
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-1545
Country	:	US
Telephone Number	:	415-244-5590
Fax Number	:	510-521-7145

Provider Business Practice Location Address
First Line	:	2000 VAN NESS AVE STE 216
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-3021
Country	:	US
Telephone Number	:	415-244-5590
Fax Number	:	510-521-7145

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2009
Last Update Date	:	06/23/2009

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