Provider Demographics
NPI:1912060419
Name:OCOMEN, MARIEFEL FAYE (ASW)
Entity Type:Individual
Prefix:MISS
First Name:MARIEFEL
Middle Name:FAYE
Last Name:OCOMEN
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:MISS
Other - First Name:FAYE
Other - Middle Name:
Other - Last Name:OCOMEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ASW
Mailing Address - Street 1:1325 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-1303
Mailing Address - Country:US
Mailing Address - Phone:510-728-8600
Mailing Address - Fax:
Practice Address - Street 1:1325 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-1303
Practice Address - Country:US
Practice Address - Phone:510-728-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA38BF3Medicaid