Provider Demographics
NPI:1427125038
Name:WEIL, JANE S (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:S
Last Name:WEIL
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 1:177 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2808
Mailing Address - Country:US
Mailing Address - Phone:510-653-4963
Mailing Address - Fax:510-653-4963
Practice Address - Street 1:47 QUAIL CT
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5567
Practice Address - Country:US
Practice Address - Phone:510-653-4963
Practice Address - Fax:510-653-4963
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 7720174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist