MEDICARE: JEANNIE OESTREICHER IMFT

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	100533	CA

General Provider Information

NPI Number	:	1477966646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNIE OESTREICHER IMFT

Provider Business Mailing Address
First Line	:	2655 CAMINO DEL RIO N STE 450
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1603
Country	:	US
Telephone Number	:	858-633-4115
Fax Number	:

Provider Business Practice Location Address
First Line	:	2655 CAMINO DEL RIO N STE 450
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1603
Country	:	US
Telephone Number	:	858-633-4115
Fax Number	:

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

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	03/14/2023

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