Provider Demographics
NPI:1063834364
Name:STEINBERG-MICHAHELLES, JANE SUSAN (LMFT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:SUSAN
Last Name:STEINBERG-MICHAHELLES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2318
Mailing Address - Country:US
Mailing Address - Phone:510-849-3009
Mailing Address - Fax:510-842-1715
Practice Address - Street 1:2728 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2318
Practice Address - Country:US
Practice Address - Phone:510-849-3009
Practice Address - Fax:510-842-1715
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25175106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist