Healthcare Provider Details

I. General information

NPI: 1629287842
Provider Name (Legal Business Name): MR. DONALD ALLEN VIEIRA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 BANCROFT AVE STE 125-A
OAKLAND CA
94605-2415
US

IV. Provider business mailing address

7200 BANCROFT AVE #125-A
OAKLAND CA
94605
US

V. Phone/Fax

Practice location:
  • Phone: 510-777-3823
  • Fax: 510-777-3806
Mailing address:
  • Phone: 510-777-3823
  • Fax: 510-777-3806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0000000
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: