Provider Demographics
NPI:1396993507
Name:STEIN-WEBBER, MARY B (MFT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:B
Last Name:STEIN-WEBBER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 BALLENA BLVD # A-5
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3679
Mailing Address - Country:US
Mailing Address - Phone:510-339-7274
Mailing Address - Fax:
Practice Address - Street 1:1138 BALLENA BLVD # A-5
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-3679
Practice Address - Country:US
Practice Address - Phone:510-339-7274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35363106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist