Healthcare Provider Details

I. General information

NPI: 1235339698
Provider Name (Legal Business Name): SHIN YI TSAI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA S. TSAI

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 TELEGRAPH AVE SUITE 12
BERKELEY CA
94705-1900
US

IV. Provider business mailing address

3120 TELEGRAPH AVE SUITE 12
BERKELEY CA
94705-1900
US

V. Phone/Fax

Practice location:
  • Phone: 510-496-2730
  • Fax:
Mailing address:
  • Phone: 510-496-2730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23959
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: