Healthcare Provider Details

I. General information

NPI: 1265716757
Provider Name (Legal Business Name): THEODORA T SINGER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 04/01/2025
Certification Date: 03/27/2025
Deactivation Date: 01/30/2013
Reactivation Date: 03/10/2025

III. Provider practice location address

220 EDMONDS RD
REDWOOD CITY CA
94062-3813
US

IV. Provider business mailing address

220 EDMONDS RD
REDWOOD CITY CA
94062-3813
US

V. Phone/Fax

Practice location:
  • Phone: 650-367-1890
  • Fax:
Mailing address:
  • Phone: 650-367-1890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20396
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: