Provider Demographics
NPI:1033771142
Name:TSUI, MARLIN ELENA (BA, IDS)
Entity Type:Individual
Prefix:MRS
First Name:MARLIN
Middle Name:ELENA
Last Name:TSUI
Suffix:
Gender:F
Credentials:BA, IDS
Other - Prefix:
Other - First Name:MARLIN
Other - Middle Name:ELENA
Other - Last Name:MARIN MATHEUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2730 SHADELANDS DR BLDG 10
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1633 BAYSHORE HWY STE 155
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1515
Practice Address - Country:US
Practice Address - Phone:650-376-4230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
EASTERSEALS174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician