MEDICARE: CHARLEEN MARY CASEY

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
1	106H00000X	Marriage & Family Therapist	53506	CA

General Provider Information

NPI Number	:	1427100346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLEEN MARY CASEY

Provider Business Mailing Address
First Line	:	5214F DIAMOND HEIGHTS BLVD # 833
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2175
Country	:	US
Telephone Number	:	415-252-0494
Fax Number	:

Provider Business Practice Location Address
First Line	:	5214F DIAMOND HEIGHTS BLVD # 833
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2175
Country	:	US
Telephone Number	:	415-939-7654
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	12/13/2023

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