Basic Information
| Provider Information | |||||||||
| NPI: | 1508069782 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | MARGOT | ||||||||
| MiddleName: | ELLEN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMFT PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3268 | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940643268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504640715 | ||||||||
| FaxNumber: | 6503659782 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 WARREN ST | ||||||||
| Address2: | #300 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940631578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504640715 | ||||||||
| FaxNumber: | 6503659782 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2007 | ||||||||
| LastUpdateDate: | 02/07/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC32053 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.