Healthcare Provider Details

I. General information

NPI: 1104003920
Provider Name (Legal Business Name): LIBBY STILL RIVERSTONE-HOWE MSW,LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 WOODSIDE RD STE 203
REDWOOD CITY CA
94061-3454
US

IV. Provider business mailing address

4368 LINCOLN AVE
OAKLAND CA
94602-2529
US

V. Phone/Fax

Practice location:
  • Phone: 650-456-1030
  • Fax:
Mailing address:
  • Phone: 510-531-3111
  • Fax: 510-530-8083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number80468
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: