Provider Demographics
NPI:1346359221
Name:CALVERT, MARGARET D (MFT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:D
Last Name:CALVERT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:D
Other - Last Name:THOMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3800 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3311
Mailing Address - Country:US
Mailing Address - Phone:510-292-9578
Mailing Address - Fax:
Practice Address - Street 1:3800 COOLIDGE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-3311
Practice Address - Country:US
Practice Address - Phone:510-292-9578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 45886106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist