Provider Demographics
NPI:1477803138
Name:CASSITY, MARCA MICHELLE (IMFT)
Entity Type:Individual
Prefix:
First Name:MARCA
Middle Name:MICHELLE
Last Name:CASSITY
Suffix:
Gender:F
Credentials:IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 OPAL ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2625
Mailing Address - Country:US
Mailing Address - Phone:510-406-3121
Mailing Address - Fax:
Practice Address - Street 1:333 VALENCIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3547
Practice Address - Country:US
Practice Address - Phone:415-503-1046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health