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General NPI Number Information
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NPI Number | 1144196841
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Entity Type | Organization
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Legal Business Name | E. LUSTIG, LICENSED CLINICAL SOCIAL WORKER P.C.
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Dates
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Enumeration Date | 10/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 3520 SOUTH CT
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City | PALO ALTO
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State | CA
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Zip | 94306-4220
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Country | US
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Telephone | 408-357-4998
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Fax |
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Provider Business Mailing Address
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Address Line | 4546 EL CAMINO REAL STE B10-825
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City | LOS ALTOS
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State | CA
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Zip | 94022-1099
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EMILY LUSTIG
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Credential | LCSW
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Telephone | 408-357-4998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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