Doctor Name: | MS. JENNIFER LYNN POOLE |
NPI Number: | 1285042622 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1 St Vincents Dr San Rafael, CA - 94903 |
Business Phone Number: | 4155072000 |
Business Fax Number: | |
Mailing Address: | 58 Tamalpias Road, BERKELEY |
State: | CA |
Postal Code: | 94708 |
Phone Number: | 4154251254 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2014 |
NPI Last Update Date: | 12/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |