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NPI Code Detail

MEDICARE: MRS. MARIE SMITH JONES M.A.

MEDICARE: MRS. MARIE SMITH JONES M.A.
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 Therapist51171CA

General Provider Information

NPI Number : 1730246901
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIE SMITH JONES M.A.
Provider Business Mailing Address
First Line : 301 JAYNE AVE APT 8
Second Line :
City : OAKLAND
State : CA
Zip : 94610-3370
Country : US
Telephone Number : 510-593-0999
Fax Number :
Provider Business Practice Location Address
First Line : 4368 LINCOLN AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94602-2529
Country : US
Telephone Number : 510-531-3111
Fax Number : 510-531-8498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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