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NPI Code Detail

MEDICARE: MS. HELENA ROSE MCMAHON LMFT

MEDICARE: MS. HELENA ROSE MCMAHON 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
1106H00000XMarriage & Family TherapistMFC42401CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112104147OTHERCAANTHEM BLUE CROSS

General Provider Information

NPI Number : 1760701734
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HELENA ROSE MCMAHON LMFT
Provider Business Mailing Address
First Line : 23 MASONIC AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94118-3417
Country : US
Telephone Number : 415-929-7171
Fax Number : 415-731-7253
Provider Business Practice Location Address
First Line : 23 MASONIC AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94118-3417
Country : US
Telephone Number : 415-929-7171
Fax Number : 415-731-7253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2010
Last Update Date : 05/28/2010

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