Provider Demographics
NPI:1417713892
Name:MARSHALL SORBO, DENA J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DENA
Middle Name:J
Last Name:MARSHALL SORBO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DENA
Other - Middle Name:J
Other - Last Name:SORBO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:900 N. SAN ANTONIO RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1307
Mailing Address - Country:US
Mailing Address - Phone:650-948-8335
Mailing Address - Fax:650-949-3776
Practice Address - Street 1:900 N. SAN ANTONIO RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1307
Practice Address - Country:US
Practice Address - Phone:650-948-8335
Practice Address - Fax:650-949-3776
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS95021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty