Healthcare Provider Details

I. General information

NPI: 1043336753
Provider Name (Legal Business Name): TONI CLAIRE MARSHALL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANTOINEITE CLAIRE MARSHALL

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 RUSSELL ST APT 1
BERKELEY CA
94705-2158
US

IV. Provider business mailing address

PO BOX 5627
BERKELEY CA
94705-0627
US

V. Phone/Fax

Practice location:
  • Phone: 530-906-8956
  • Fax: 530-823-3707
Mailing address:
  • Phone: 530-906-8956
  • Fax: 530-823-3707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS14866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: