Healthcare Provider Details

I. General information

NPI: 1497915714
Provider Name (Legal Business Name): MS. DENA M MASUDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 CLEMENT AVE
ALAMEDA CA
94501-1421
US

IV. Provider business mailing address

2325 CLEMENT AVE
ALAMEDA CA
94501-1421
US

V. Phone/Fax

Practice location:
  • Phone: 510-629-6300
  • Fax: 510-865-1930
Mailing address:
  • Phone: 510-629-6300
  • Fax: 510-865-1930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: