Healthcare Provider Details

I. General information

NPI: 1447432042
Provider Name (Legal Business Name): MS. VICTORIA ROSE LEFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 09/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 SCENIC AVE
BERKELEY CA
94709-1324
US

IV. Provider business mailing address

2323 HEARST AVE
BERKELEY CA
94709-1319
US

V. Phone/Fax

Practice location:
  • Phone: 510-548-7270
  • Fax: 510-548-1060
Mailing address:
  • Phone: 510-526-6200
  • Fax: 510-665-3176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: