Provider Demographics
NPI:1962520981
Name:COHEN, LEAH (ASW, PPSC)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:ASW, PPSC
Other - Prefix:MISS
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, PPSC
Mailing Address - Street 1:1220 TASMAN DR SPC 123
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94089-2442
Mailing Address - Country:US
Mailing Address - Phone:650-796-9819
Mailing Address - Fax:
Practice Address - Street 1:650 CLARK WAY
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2300
Practice Address - Country:US
Practice Address - Phone:650-688-3697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA189411041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool