Provider Demographics
NPI:1972576221
Name:LEVINE, JOSIE LEVINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSIE
Middle Name:LEVINE
Last Name:LEVINE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 MOUNTAIN BLVD.
Mailing Address - Street 2:STE. 240
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611
Mailing Address - Country:US
Mailing Address - Phone:510-524-1720
Mailing Address - Fax:510-530-6231
Practice Address - Street 1:2220 MOUNTAIN BLVD.
Practice Address - Street 2:STE. 240
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611
Practice Address - Country:US
Practice Address - Phone:510-524-1720
Practice Address - Fax:510-530-6231
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT28557101YM0800X
CAMFT25887106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health