Healthcare Provider Details

I. General information

NPI: 1881587624
Provider Name (Legal Business Name): AMIRA WASHINGTON N.C.C., CMPSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 TELEGRAPH AVE STE 501
BERKELEY CA
94705-1151
US

IV. Provider business mailing address

2855 TELEGRAPH AVE STE 501
BERKELEY CA
94705-1151
US

V. Phone/Fax

Practice location:
  • Phone: 510-835-5010
  • Fax: 510-835-9232
Mailing address:
  • Phone: 510-835-5010
  • Fax: 510-835-9232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: