MEDICARE: SAMANTHA LAUREN WEISS 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	129139	CA

General Provider Information

NPI Number	:	1841807914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA LAUREN WEISS LCSW

Provider Business Mailing Address
First Line	:	PO BOX 6313
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-0313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1870 OLYMPIC BLVD
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-8588
Country	:	US
Telephone Number	:	925-830-7900
Fax Number	:

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

Provider Enumeration Date	:	09/23/2020
Last Update Date	:	06/01/2026

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