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MS. JILL LOUISE ANDERSON PSYD

>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1386805661

Individual Registrant:
MS. JILL LOUISE ANDERSON PSYD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
2400 BRIDGEWAY  SAUSALITO, CA 94965-2850 US
Tel: 415-272-6850  Fax: --

Contact information for business:
PO BOX 204  SAUSALITO, CA 94966-0204 US
Tel: 415-272-6850  Fax: 415-664-7094

Registration Information:
NPI: 1386805661
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101Y00000XBehavioral Health & Social Service Providers
Counselor
N103T00000XBehavioral Health & Social Service Providers
Psychologist
N390200000XStudent
Organized Health Care Education/Training Program
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
CA31904

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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