Provider Demographics
NPI:1962553644
Name:TURRET, MAXINE LEE (LCSW, BCD)
Entity type:Individual
Prefix:
First Name:MAXINE
Middle Name:LEE
Last Name:TURRET
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4266 ATLAS AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-1633
Mailing Address - Country:US
Mailing Address - Phone:510-530-5889
Mailing Address - Fax:
Practice Address - Street 1:280 W MACARTHUR BLVD
Practice Address - Street 2:DEPT. OF PSYCHIATRY
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5642
Practice Address - Country:US
Practice Address - Phone:510-752-1429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 69571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical