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NPI Code Detail

MEDICARE: MRS. ROSEMARY ELIZABETH LUM-LEVINE SOCIAL WORKER

MEDICARE: MRS. ROSEMARY ELIZABETH LUM-LEVINE SOCIAL WORKER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker0519671NY
21041C0700XClinical Social Worker0519671NY
31041C0700XClinical Social Worker28736CA

General Provider Information

NPI Number : 1407990633
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROSEMARY ELIZABETH LUM-LEVINE SOCIAL WORKER
Provider Business Mailing Address
First Line : 2344 6TH ST
Second Line :
City : BERKELEY
State : CA
Zip : 94710-2412
Country : US
Telephone Number : 510-981-3203
Fax Number : 510-553-2169
Provider Business Practice Location Address
First Line : 2620 26TH AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94601-1907
Country : US
Telephone Number : 510-437-2363
Fax Number : 510-437-2366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2007
Last Update Date : 07/10/2015

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