Provider Demographics
NPI:1952784134
Name:LEVIT, JUDY ANNE
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANNE
Last Name:LEVIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ANNE
Other - Last Name:LEVIT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:2137 TIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-2537
Mailing Address - Country:US
Mailing Address - Phone:510-915-4631
Mailing Address - Fax:
Practice Address - Street 1:2071 ANTIOCH CT STE 202
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2955
Practice Address - Country:US
Practice Address - Phone:510-339-6651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32429106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist