| Doctor Name: | MARY VIRGINIA JEFFRIES |
| NPI Number: | 1114051281 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | ASW12041 |
| Business Practice Address: | 11565 Laurel Canyon Blvd #100 San Fernando, CA - 913404168 |
| Business Phone Number: | 8183654723 |
| Business Fax Number: | 8183653475 |
| Mailing Address: | 638 N Mar Vista Ave, PASADENA |
| State: | CA |
| Postal Code: | 911061127 |
| Phone Number: | 6267939226 |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225400000X |
| License Number: | ASW12041 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Rehabilitation Practitioner |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |