MEDICARE: MS. MARSHA WEINBERG LCSW

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	1041C0700X	Clinical Social Worker	LCS10924	CA

General Provider Information

NPI Number	:	1740270222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARSHA WEINBERG LCSW

Provider Business Mailing Address
First Line	:	5230 CARROLL CANYON RD
Second Line	:	STE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1779
Country	:	US
Telephone Number	:	858-243-4850
Fax Number	:	888-650-1004

Provider Business Practice Location Address
First Line	:	5230 CARROLL CANYON RD
Second Line	:	STE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1779
Country	:	US
Telephone Number	:	858-243-4850
Fax Number	:	888-650-1004

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	03/15/2017

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