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NPI Code Detail

MEDICARE: MS. MARY JO VOLK M.A., M.F.T.

MEDICARE: MS. MARY JO VOLK M.A., 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 TherapistMFC39422CA

General Provider Information

NPI Number : 1902922263
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY JO VOLK M.A., M.F.T.
Provider Business Mailing Address
First Line : 866 LA VINA LN
Second Line :
City : ALTADENA
State : CA
Zip : 91001-3754
Country : US
Telephone Number : 626-345-9935
Fax Number : 626-345-9222
Provider Business Practice Location Address
First Line : 867 ATCHISON ST
Second Line :
City : PASADENA
State : CA
Zip : 91104-2314
Country : US
Telephone Number : 626-798-0915
Fax Number : 626-798-1850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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