Healthcare Provider Details

I. General information

NPI: 1366082950
Provider Name (Legal Business Name): LA TRONDA SHAWNA LUMPKINS MSW, MBA, ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 W MACARTHUR BLVD
OAKLAND CA
94609-2808
US

IV. Provider business mailing address

1675 7TH ST UNIT 24623
OAKLAND CA
94615-0002
US

V. Phone/Fax

Practice location:
  • Phone: 877-459-6463
  • Fax: --
Mailing address:
  • Phone: 510-575-1370
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberACSW104070
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberACSW104070
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: