Healthcare Provider Details

I. General information

NPI: 1275814642
Provider Name (Legal Business Name): KAREN ELIZABETH CANAPE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 ROLAND WAY STE 100
OAKLAND CA
94621
US

IV. Provider business mailing address

401 ROLAND WAY STE 100
OAKLAND CA
94621-2034
US

V. Phone/Fax

Practice location:
  • Phone: 510-746-2800
  • Fax:
Mailing address:
  • Phone: 510-746-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberASW76766
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberASW76766
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW82710
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: