MEDICARE: JANE SUSAN STEINBERG-MICHAHELLES LMFT

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	MFC25175	CA

General Provider Information

NPI Number	:	1063834364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE SUSAN STEINBERG-MICHAHELLES LMFT

Provider Business Mailing Address
First Line	:	2728 RUSSELL ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2318
Country	:	US
Telephone Number	:	510-849-3009
Fax Number	:	510-842-1715

Provider Business Practice Location Address
First Line	:	2728 RUSSELL ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2318
Country	:	US
Telephone Number	:	510-849-3009
Fax Number	:	510-842-1715

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

Provider Enumeration Date	:	01/06/2014
Last Update Date	:	01/06/2014

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