Healthcare Provider Details

I. General information

NPI: 1164835393
Provider Name (Legal Business Name): MARKIAS LITTLEJOHN DBH, LCSW, CST, LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MARKIAS KAIYAN LITTLEJOHN DBH, LCSW,CST, LISWC

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 OCEAN AVE # 234
SAN FRANCISCO CA
94112-1737
US

IV. Provider business mailing address

1728 OCEAN AVE # 234
SAN FRANCISCO CA
94112-1737
US

V. Phone/Fax

Practice location:
  • Phone: 562-608-6774
  • Fax:
Mailing address:
  • Phone: 562-608-6774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5651
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number76236
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number76236
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number5651
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number76236
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number67755
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number67755
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13049
License Number StateSC
# 9
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number13049
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: