Healthcare Provider Details

I. General information

NPI: 1245107820
Provider Name (Legal Business Name): SAMANTHA HUGGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 CENTRAL AVE
ALAMEDA CA
94501-4411
US

IV. Provider business mailing address

2060 CHALLENGER DR
ALAMEDA CA
94501-1037
US

V. Phone/Fax

Practice location:
  • Phone: 510-337-7022
  • Fax:
Mailing address:
  • Phone: 510-337-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number220179168
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: