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NPI Code Detail

MEDICARE: MR. JULIAN OLIVER REDWOOD M.F.T

MEDICARE: MR. JULIAN OLIVER REDWOOD M.F.T
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 TherapistMFT 47939CA

General Provider Information

NPI Number : 1497047120
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JULIAN OLIVER REDWOOD M.F.T
Provider Business Mailing Address
First Line : 1944 FILLMORE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-2745
Country : US
Telephone Number : 415-806-5585
Fax Number : 415-440-6979
Provider Business Practice Location Address
First Line : 1944 FILLMORE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-2745
Country : US
Telephone Number : 415-806-5585
Fax Number : 415-440-6979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2011
Last Update Date : 05/13/2011

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