Provider Demographics
NPI:1851505986
Name:SEGALL, JOAN BERMAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:BERMAN
Last Name:SEGALL
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 1:230 S CALIFORNIA AVE
Mailing Address - Street 2:STE.200
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1642
Mailing Address - Country:US
Mailing Address - Phone:650-322-5102
Mailing Address - Fax:
Practice Address - Street 1:230 S CALIFORNIA AVE
Practice Address - Street 2:STE.200
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1642
Practice Address - Country:US
Practice Address - Phone:650-322-5102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8935101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health