Provider Demographics
NPI:1710110150
Name:BLUMBERG, MARGARET (PEGGY) (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARET (PEGGY)
Middle Name:
Last Name:BLUMBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:BLUMBERG
Other - Last Name:KOSTICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:910 TULARE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2112
Mailing Address - Country:US
Mailing Address - Phone:510-292-4070
Mailing Address - Fax:510-848-9282
Practice Address - Street 1:910 TULARE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94707-2112
Practice Address - Country:US
Practice Address - Phone:510-292-4070
Practice Address - Fax:510-848-9282
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS63281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical