Provider Demographics
NPI:1407990633
Name:LUM-LEVINE, ROSEMARY ELIZABETH (SOCIAL WORKER)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:ELIZABETH
Last Name:LUM-LEVINE
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:ELIZABETH
Other - Last Name:LUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SOCIAL WORKER
Mailing Address - Street 1:2344 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2412
Mailing Address - Country:US
Mailing Address - Phone:510-981-3203
Mailing Address - Fax:510-553-2169
Practice Address - Street 1:2620 26TH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-1907
Practice Address - Country:US
Practice Address - Phone:510-437-2363
Practice Address - Fax:510-437-2366
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0519671104100000X, 1041C0700X
CA287361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker