Healthcare Provider Details

I. General information

NPI: 1750731816
Provider Name (Legal Business Name): EMILY PANGILINAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 UNIVERSITY AVE
BERKELEY CA
94703-1422
US

IV. Provider business mailing address

18 WEXFORD PL
ALAMEDA CA
94502-7713
US

V. Phone/Fax

Practice location:
  • Phone: 510-981-5239
  • Fax: 510-542-4580
Mailing address:
  • Phone: 510-355-5547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number129522
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: