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NPI Code Detail

MEDICARE: JUDITH ANNE BOORE MFT

MEDICARE: JUDITH ANNE BOORE MFT
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 TherapistMFC30619CA

General Provider Information

NPI Number : 1285617589
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH ANNE BOORE MFT
Provider Business Mailing Address
First Line : 871 FREMONT AVE
Second Line : STE.107
City : LOS ALTOS
State : CA
Zip : 94024-5617
Country : US
Telephone Number : 650-948-9138
Fax Number :
Provider Business Practice Location Address
First Line : 871 FREMONT AVE
Second Line : STE. 107
City : LOS ALTOS
State : CA
Zip : 94024-5617
Country : US
Telephone Number : 650-948-9138
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 07/08/2007

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Directions to “ JUDITH ANNE BOORE MFT” Practice Location

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