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NPI Code Detail

MEDICARE: ADAM H. B. MCDONALD M.A.

MEDICARE: ADAM H. B. MCDONALD 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 Therapist41528CA

General Provider Information

NPI Number : 1790124329
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM H. B. MCDONALD M.A.
Provider Business Mailing Address
First Line : PO BOX 13
Second Line :
City : RAIL ROAD FLAT
State : CA
Zip : 95248-0013
Country : US
Telephone Number : 209-754-9173
Fax Number : 209-754-9173
Provider Business Practice Location Address
First Line : 1001 BROADWAY
Second Line : SUITE 105
City : JACKSON
State : CA
Zip : 95642-2649
Country : US
Telephone Number : 209-754-9173
Fax Number : 209-754-9173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2013
Last Update Date : 06/17/2013

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