Healthcare Provider Details

I. General information

NPI: 1518415264
Provider Name (Legal Business Name): REBECCA OSBURNE-ROTHSTEIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 STARDUST PL
ALAMEDA CA
94501-7251
US

IV. Provider business mailing address

2325 CLEMENT AVE STE A
ALAMEDA CA
94501-7061
US

V. Phone/Fax

Practice location:
  • Phone: 510-629-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number087811
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100774
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: