Healthcare Provider Details

I. General information

NPI: 1508651969
Provider Name (Legal Business Name): EMMA JANSSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10850 MACARTHUR BLVD
OAKLAND CA
94605-5266
US

IV. Provider business mailing address

459 38TH ST STE A
OAKLAND CA
94609-2732
US

V. Phone/Fax

Practice location:
  • Phone: 510-875-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15149
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: