Jeri Lynn Leise in Santa Rosa - Marriage & Family Therapist
Jeri Lynn Leise - NPI 1720209117
Jeri Lynn Leise is a Marriage & Family Therapist in Santa Rosa, California. Jeri Lynn Leise practices all healthcare services and medical treatments related to Marriage & Family Therapist. The NPI Number for Jeri Lynn Leise is 1720209117. The last update date is 2007-07-08.
Jeri Lynn Leise's current location address is Po Box 194, Santa Rosa, California. You can contact this provider via phone number 7074865570 and fax number 7075790809. The mailing address for Jeri Lynn Leise is Po Box 194, Santa Rosa, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeri Lynn Leise |
|---|---|
| Address | Po Box 194, Santa Rosa, California |
| Phone Number | 7074865570 |
| Fax Number | 7075790809 |
| Sole Proprietor | Y |
| Credentials | MFT |
NPI Number Detail
| NPI Number | 1720209117 |
|---|---|
| Provider Enumeration Date | 2007-05-01 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | Po Box 194 |
|---|---|
| City | Santa Rosa |
| State | California (CA) |
| Post Code | 954020194 |
| Phone Number | 7074865570 |
| Fax Number | 7075790809 |
Provider's Primary Taxonomy Detail
| Speciality | Marriage & Family Therapist |
|---|---|
| Taxonomy | 106H00000X |
| Licence No | MFC36649 |
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Definition: A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives |
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What is the unique 10-digit identifier code assigned to Jeri Lynn Leise by the Centers for Medicare & Medicaid Services?
The Jeri Lynn Leise has been issued the NPI (National Provider Identifier) 1720209117 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Jeri Lynn Leise's facilities are geographically located?
The facilities of Jeri Lynn Leise are physically situated at the following location: Po Box 194, Santa Rosa, CA, 954020194.
What is Jeri Lynn Leise's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jeri Lynn Leise's area of specialization is Marriage & Family Therapist, and the corresponding taxonomy code that categorizes this field of practice is 106H00000X.
On what date did the Jeri Lynn Leise receive its 1720209117 assignment from the Centers for Medicare & Medicaid Services?
The Jeri Lynn Leise was assigned its 1720209117 by the Centers for Medicare & Medicaid Services on 2007-05-01.
When was the information regarding Jeri Lynn Leise most recently updated?
The details pertaining to the Jeri Lynn Leise, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.