=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881749687
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARSHA KAY WEINSTEIN L.C.S.W.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2007
-----------------------------------------------------
Last Update Date | 05/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5655 LINDERO CANYON RD. #225
-----------------------------------------------------
City | WESTLAKE VILLAGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91362-4046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-707-3235
-----------------------------------------------------
Fax | 818-874-9528
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5655 LINDERO CANYON RD. #225
-----------------------------------------------------
City | WESTLAKE VILLAGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91362-4046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-707-3235
-----------------------------------------------------
Fax | 818-874-9528
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LCS7272
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------