Provider Demographics
NPI:1215306733
Name:PEDJOE, PAMELA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:MARIE
Last Name:PEDJOE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:PAMARIE
Other - Middle Name:
Other - Last Name:PEDJOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA,LMFT
Mailing Address - Street 1:1170 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3312
Mailing Address - Country:US
Mailing Address - Phone:510-506-6208
Mailing Address - Fax:
Practice Address - Street 1:1170 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3312
Practice Address - Country:US
Practice Address - Phone:510-506-6208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88484106H00000X
ORT2983106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist