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General NPI Number Information
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NPI Number | 1528536877
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Entity Type | Individual
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Provider Name | MARNIE KAGAN WESTON PHD
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Gender | Female
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Dates
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Enumeration Date | 11/05/2018
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 225 CABRILLO HWY S STE 208C
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City | HALF MOON BAY
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State | CA
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Zip | 94019-7200
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Country | US
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Telephone | 650-867-7126
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Fax | 833-211-2467
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Provider Business Mailing Address
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Address Line | PO BOX 165
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City | EL GRANADA
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State | CA
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Zip | 94018-0165
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Country | US
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Telephone | 650-867-7126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY30357
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License Number State | CA
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