Provider Demographics
NPI:1417773433
Name:DRIVER, JAMIA (MS, ALC)
Entity type:Individual
Prefix:MS
First Name:JAMIA
Middle Name:
Last Name:DRIVER
Suffix:
Gender:F
Credentials:MS, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1550
Mailing Address - Country:US
Mailing Address - Phone:800-273-8255
Mailing Address - Fax:
Practice Address - Street 1:4315 GOLF CLUB DR APT 711
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5843
Practice Address - Country:US
Practice Address - Phone:334-870-9029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional