Provider Demographics
NPI:1619043437
Name:ENGLISH, MARLA JEAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARLA
Middle Name:JEAN
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 WASHINGTON ST
Mailing Address - Street 2:# 625
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2110
Mailing Address - Country:US
Mailing Address - Phone:619-296-6810
Mailing Address - Fax:858-279-8398
Practice Address - Street 1:11026 PALLON WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-2719
Practice Address - Country:US
Practice Address - Phone:619-296-6810
Practice Address - Fax:858-279-8398
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS183711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW18371Medicare ID - Type Unspecified