Healthcare Provider Details

I. General information

NPI: 1255363461
Provider Name (Legal Business Name): ERICA FELDMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 SOLANO AVE # A01
BERKELEY CA
94707-2209
US

IV. Provider business mailing address

1791 SOLANO AVE # A01
BERKELEY CA
94707-2209
US

V. Phone/Fax

Practice location:
  • Phone: 510-646-0128
  • Fax:
Mailing address:
  • Phone: 510-646-0128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25552
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: