Provider Demographics
NPI:1528216967
Name:MIDDLETON, JEFFREY TODD (LCSW)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:TODD
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1868 CLAYTON RD STE 220
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2503
Mailing Address - Country:US
Mailing Address - Phone:925-768-1586
Mailing Address - Fax:925-458-6981
Practice Address - Street 1:155 SHARENE LN APT 115
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4782
Practice Address - Country:US
Practice Address - Phone:925-768-1585
Practice Address - Fax:925-458-6981
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS233971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical