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NPI Code Detail

MEDICARE: LISA NICOLE KLEINZWEIG LCSW, PPSC

MEDICARE: LISA NICOLE KLEINZWEIG LCSW, PPSC
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
11041S0200XSchool Social Worker75409CA
21041C0700XClinical Social WorkerLCSW75409CA

General Provider Information

NPI Number : 1427338029
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA NICOLE KLEINZWEIG LCSW, PPSC
Provider Business Mailing Address
First Line : 1685 ROSE AVE
Second Line :
City : SANTA ROSA
State : CA
Zip : 95407-7176
Country : US
Telephone Number : 831-359-7562
Fax Number :
Provider Business Practice Location Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-377-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2011
Last Update Date : 06/15/2026

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