Provider Demographics
NPI:1073174058
Name:LINDENBAUM, JOYCE (LCSW)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:LINDENBAUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5435 COLLEGE AVE.
Mailing Address - Street 2:STE 202
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618
Mailing Address - Country:US
Mailing Address - Phone:510-601-9171
Mailing Address - Fax:
Practice Address - Street 1:5435 COLLEGE AVE.
Practice Address - Street 2:STE 202
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618
Practice Address - Country:US
Practice Address - Phone:510-601-9171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TP0814X
CALCSW83541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis