Provider Demographics
NPI:1063528222
Name:METOLIUS, JONI (MFT)
Entity type:Individual
Prefix:MS
First Name:JONI
Middle Name:
Last Name:METOLIUS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-1942
Mailing Address - Country:US
Mailing Address - Phone:415-209-9991
Mailing Address - Fax:415-209-9993
Practice Address - Street 1:2680 CENTER ROAD
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-1942
Practice Address - Country:US
Practice Address - Phone:415-209-9991
Practice Address - Fax:415-209-9993
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC11981106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist