MEDICARE: BRENDA C JOE-MATSUO M.S., 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
1	106H00000X	Marriage & Family Therapist	MFC37687	CA

General Provider Information

NPI Number	:	1316148778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA C JOE-MATSUO M.S., MFT

Provider Business Mailing Address
First Line	:	947 ARUBA LN
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-3801
Country	:	US
Telephone Number	:	650-341-5070
Fax Number	:

Provider Business Practice Location Address
First Line	:	39155 LIBERTY STREET
Second Line	:	SUITE E500
City	:	FREMONT
State	:	CA
Zip	:	94537-5006
Country	:	US
Telephone Number	:	510-574-2100
Fax Number	:

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

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	07/08/2007

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