Provider Demographics
NPI:1144406364
Name:STONE, MARLA BRENDA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARLA
Middle Name:BRENDA
Last Name:STONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2730 CAMINO CAPISTRANO
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4847
Mailing Address - Country:US
Mailing Address - Phone:949-709-7000
Mailing Address - Fax:949-498-1200
Practice Address - Street 1:2730 CAMINO CAPISTRANO
Practice Address - Street 2:SUITE 3
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4847
Practice Address - Country:US
Practice Address - Phone:949-709-7000
Practice Address - Fax:949-498-1200
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA213161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical