Provider Demographics
NPI:1740270222
Name:WEINBERG, MARSHA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:
Last Name:WEINBERG
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 1:5230 CARROLL CANYON RD
Mailing Address - Street 2:STE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1779
Mailing Address - Country:US
Mailing Address - Phone:858-243-4850
Mailing Address - Fax:888-650-1004
Practice Address - Street 1:5230 CARROLL CANYON RD
Practice Address - Street 2:STE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1779
Practice Address - Country:US
Practice Address - Phone:858-243-4850
Practice Address - Fax:888-650-1004
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS109241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW10924Medicare ID - Type UnspecifiedMEDICARE