Provider Demographics
NPI:1790543437
Name:MEADOWS, MARIAN (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:MEADOWS
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 1:19400 SANTA MARIA AVE
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-3400
Mailing Address - Country:US
Mailing Address - Phone:510-537-5910
Mailing Address - Fax:
Practice Address - Street 1:19400 SANTA MARIA AVE
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-3400
Practice Address - Country:US
Practice Address - Phone:510-537-6591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA421381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical