MEDICARE: DR. JILL NOREEN WARBURTON PSY.D.

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
1	103TC0700X	Clinical Psychologist	PSY20773	CA

General Provider Information

NPI Number	:	1952450991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL NOREEN WARBURTON PSY.D.

Provider Business Mailing Address
First Line	:	411 PRENTISS ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-6142
Country	:	US
Telephone Number	:	415-816-8603
Fax Number	:	415-826-5455

Provider Business Practice Location Address
First Line	:	2481 CLAY ST STE 202B
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-1808
Country	:	US
Telephone Number	:	415-922-7793
Fax Number	:	415-826-5455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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