Healthcare Provider Details

I. General information

NPI: 1427338029
Provider Name (Legal Business Name): LISA NICOLE KLEINZWEIG LCSW, PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8945 GOLF LINKS RD
OAKLAND CA
94605-4124
US

IV. Provider business mailing address

1685 ROSE AVE
SANTA ROSA CA
95407-7176
US

V. Phone/Fax

Practice location:
  • Phone: 510-377-1444
  • Fax:
Mailing address:
  • Phone: 831-359-7562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number75409
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW75409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: