Provider Demographics
NPI:1649943622
Name:WALDRON, MARGO LEIGH (LMFT)
Entity type:Individual
Prefix:MS
First Name:MARGO
Middle Name:LEIGH
Last Name:WALDRON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1617
Mailing Address - Country:US
Mailing Address - Phone:510-846-6345
Mailing Address - Fax:
Practice Address - Street 1:1915 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1617
Practice Address - Country:US
Practice Address - Phone:510-846-6345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95997106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist