Jedidiah Purses, AMFT
Counselor, Mental Health in Corte Madera, CA. Individual provider (NPI-1).
NPI number1609415207
StatusActive
Last updated in NPPESDec 30, 2019
Details
- NPI
- 1609415207
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jedidiah Purses
- Credential
- AMFT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 30, 2019
- Certification date
- Dec 30, 2019
- Last updated
- Dec 30, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 111405 | CA | Yes |
Practice location
300 Tamal Plz Ste 220Corte Madera, CA 94925-1136
Phone 415-459-5206
Mailing address
300 Tamal Plz Ste 220Corte Madera, CA 94925-1136
Phone 415-459-5206
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