Provider Demographics
NPI:1548219033
Name:ORLIN, PEGGY (MFT)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:
Last Name:ORLIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 STANNAGE AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1031
Mailing Address - Country:US
Mailing Address - Phone:510-528-2750
Mailing Address - Fax:415-834-3025
Practice Address - Street 1:925 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2310
Practice Address - Country:US
Practice Address - Phone:510-528-2750
Practice Address - Fax:415-834-3025
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 19066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health