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General NPI Number Information
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NPI Number | 1902969322
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Entity Type | Individual
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Provider Name | MARLENE LOUISE LEVENSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 200 CHANNING AVE
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City | PALO ALTO
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State | CA
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Zip | 94301-2720
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Country | US
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Telephone | 650-688-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 1307 ASHWOOD CT
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City | SAN MATEO
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State | CA
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Zip | 94402-3317
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Country | US
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Telephone | 650-349-9535
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS15368
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License Number State | CA
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