Provider Demographics
NPI:1245905157
Name:GIVENS, MARCUS (M DOV)
Entity type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:
Last Name:GIVENS
Suffix:
Gender:M
Credentials:M DOV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 KIFER RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-0719
Mailing Address - Country:US
Mailing Address - Phone:408-843-7245
Mailing Address - Fax:
Practice Address - Street 1:3335 KIFER RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-0719
Practice Address - Country:US
Practice Address - Phone:408-843-7245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator