Healthcare Provider Details

I. General information

NPI: 1023361284
Provider Name (Legal Business Name): SHAD'E ANGELA PINKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 BISSO LN STE 100
CONCORD CA
94520-4817
US

IV. Provider business mailing address

2425 BISSO LN STE 100
CONCORD CA
94520-4817
US

V. Phone/Fax

Practice location:
  • Phone: 925-521-5628
  • Fax: 925-521-5639
Mailing address:
  • Phone: 925-521-5628
  • Fax: 925-521-5639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number112352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: