Provider Demographics
NPI:1629269162
Name:TOBIAS, MERIDEL PEARL (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MERIDEL
Middle Name:PEARL
Last Name:TOBIAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:MERIDEL
Other - Middle Name:PEARL
Other - Last Name:NORDLEY-KNOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:1791 SOLANO AV, # F12
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2209
Mailing Address - Country:US
Mailing Address - Phone:612-868-9208
Mailing Address - Fax:510-601-4002
Practice Address - Street 1:1850 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707
Practice Address - Country:US
Practice Address - Phone:510-379-4860
Practice Address - Fax:510-601-4002
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56385106H00000X
CA48745106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist