MEDICARE: MARSHA CHILDS 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
1	1041C0700X	Clinical Social Worker	15427	CA

General Provider Information

NPI Number	:	1326103326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHA CHILDS LCSW

Provider Business Mailing Address
First Line	:	5737 KANAN RD # 331
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1601
Country	:	US
Telephone Number	:	415-328-9502
Fax Number	:	530-233-9619

Provider Business Practice Location Address
First Line	:	3717 E THOUSAND OAKS BLVD STE 276
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3607
Country	:	US
Telephone Number	:	415-328-9502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	04/03/2026

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