MEDICARE: JUNE B TIMBERLAKE LMFT

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	MFC32781	CA

General Provider Information

NPI Number	:	1437274164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNE B TIMBERLAKE LMFT

Provider Business Mailing Address
First Line	:	39899 BALENTINE DR
Second Line	:	SUITE 310
City	:	NEWARK
State	:	CA
Zip	:	94560-5355
Country	:	US
Telephone Number	:	510-979-0200
Fax Number	:	510-979-0201

Provider Business Practice Location Address
First Line	:	39899 BALENTINE DR
Second Line	:	SUITE 310
City	:	NEWARK
State	:	CA
Zip	:	94560-5355
Country	:	US
Telephone Number	:	510-979-0200
Fax Number	:	510-979-0201

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/08/2007

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Directions to “ JUNE B TIMBERLAKE LMFT” Practice Location

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