Healthcare Provider Details

I. General information

NPI: 1336006758
Provider Name (Legal Business Name): MARISA ANN WEINSTOCK ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RISA WEINSTOCK ASW

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 MOUNTAIN BLVD
OAKLAND CA
94611-2259
US

IV. Provider business mailing address

3 15TH AVE
SAN FRANCISCO CA
94118-1008
US

V. Phone/Fax

Practice location:
  • Phone: 510-879-3143
  • Fax:
Mailing address:
  • Phone: 415-710-5799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberASW124987
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: