Provider Demographics
NPI:1992270490
Name:LITMANOWICZ, ALINE
Entity type:Individual
Prefix:
First Name:ALINE
Middle Name:
Last Name:LITMANOWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 WALNUT ST APT 201
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1761
Mailing Address - Country:US
Mailing Address - Phone:707-836-3714
Mailing Address - Fax:
Practice Address - Street 1:20 N SAN PEDRO RD STE 2021
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4158
Practice Address - Country:US
Practice Address - Phone:707-836-3714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health