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NPI Code Detail

MEDICARE: EDEN MARCHANT LCSW

MEDICARE: EDEN MARCHANT LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker31632CA

General Provider Information

NPI Number : 1184037491
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDEN MARCHANT LCSW
Provider Business Mailing Address
First Line : 1011 UNION ST
Second Line :
City : OAKLAND
State : CA
Zip : 94607-2236
Country : US
Telephone Number : 510-871-3336
Fax Number :
Provider Business Practice Location Address
First Line : 1011 UNION ST
Second Line :
City : OAKLAND
State : CA
Zip : 94607-2236
Country : US
Telephone Number : 510-871-3336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2014
Last Update Date : 01/03/2022

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Directions to “ EDEN MARCHANT LCSW” Practice Location

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