Healthcare Provider Details

I. General information

NPI: 1316073281
Provider Name (Legal Business Name): HOWARD I LEVENE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 HELENS LN
MILL VALLEY CA
94941-2683
US

IV. Provider business mailing address

141 HELENS LN
MILL VALLEY CA
94941-2683
US

V. Phone/Fax

Practice location:
  • Phone: 415-342-3048
  • Fax: 415-598-1800
Mailing address:
  • Phone: 415-342-3048
  • Fax: 415-598-1800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG0008344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: