Doctor Name: | STEPHEN MARTIN ODE |
NPI Number: | 1124164868 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LCS10505 |
Business Practice Address: | 19000 Homestead Rd Cupertino, CA - 950140712 |
Business Phone Number: | 4083664450 |
Business Fax Number: | |
Mailing Address: | 19000 Homestead Rd, CUPERTINO |
State: | CA |
Postal Code: | 950140712 |
Phone Number: | 4083664450 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS10505 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |