Provider Demographics
NPI:1184058471
Name:MARRON, SERGIO ALBERTO (LCSW)
Entity type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:ALBERTO
Last Name:MARRON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-5173
Mailing Address - Country:US
Mailing Address - Phone:209-381-2000
Mailing Address - Fax:
Practice Address - Street 1:3605 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-5173
Practice Address - Country:US
Practice Address - Phone:209-381-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-22
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA871881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical