MEDICARE: MS. MARY FRANCES WALSHE 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
1	106H00000X	Marriage & Family Therapist	MFC32800	CA

General Provider Information

NPI Number	:	1245311877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY FRANCES WALSHE M.A.

Provider Business Mailing Address
First Line	:	3920 W LAND PARK DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95822-1123
Country	:	US
Telephone Number	:	916-448-3578
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 HOWE AVE
Second Line	:	SUITE 520
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-4731
Country	:	US
Telephone Number	:	916-733-6354
Fax Number	:	916-733-6359

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/08/2007

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