MEDICARE: MR. JAMES JOSEPH BIRKOSKI MA

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	IMF47446	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CBSC058	OTHER	CA	LA DMH PROVIDER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396865895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES JOSEPH BIRKOSKI MA

Provider Business Mailing Address
First Line	:	15237 CALLE SAN LUIS POTOSI
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91390-1091
Country	:	US
Telephone Number	:	661-270-1201
Fax Number	:

Provider Business Practice Location Address
First Line	:	15237 CALLE SAN LUIS POTOSI
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91390-1091
Country	:	US
Telephone Number	:	661-270-1201
Fax Number	:

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/09/2007

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