MEDICARE: ERIN LEIGH MCQUEEN AMFT

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	143733	CA

General Provider Information

NPI Number	:	1144080615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN LEIGH MCQUEEN AMFT

Provider Business Mailing Address
First Line	:	5123 CORONADO AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94618-1003
Country	:	US
Telephone Number	:	925-518-8457
Fax Number	:

Provider Business Practice Location Address
First Line	:	822 D ST # 4
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-2814
Country	:	US
Telephone Number	:	510-603-7400
Fax Number	:

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

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	03/20/2024

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Directions to “ ERIN LEIGH MCQUEEN AMFT” Practice Location

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