Provider Demographics
NPI:1144080615
Name:MCQUEEN, ERIN LEIGH (AMFT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LEIGH
Last Name:MCQUEEN
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5123 CORONADO AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1003
Mailing Address - Country:US
Mailing Address - Phone:925-518-8457
Mailing Address - Fax:
Practice Address - Street 1:822 D ST # 4
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2814
Practice Address - Country:US
Practice Address - Phone:510-603-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143733106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist