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NPI Code Detail

MEDICARE: MS. PATRICIA RAE COBB M. A.

MEDICARE: MS. PATRICIA RAE COBB M. A.
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
1106H00000XMarriage & Family Therapist000578CT

General Provider Information

NPI Number : 1144385220
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA RAE COBB M. A.
Provider Business Mailing Address
First Line : 4551 HEAFEY RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4626
Country : US
Telephone Number : 510-568-2159
Fax Number :
Provider Business Practice Location Address
First Line : 4368 LINCOLN AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94602-2529
Country : US
Telephone Number : 510-531-3111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2006
Last Update Date : 07/08/2007

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