Healthcare Provider Details

I. General information

NPI: 1891413928
Provider Name (Legal Business Name): MELANIA WINSLOW MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2022
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 GRAND AVE STE 200
OAKLAND CA
94610-5060
US

IV. Provider business mailing address

2041 36TH AVE APT 2
OAKLAND CA
94601-3636
US

V. Phone/Fax

Practice location:
  • Phone: 510-717-2751
  • Fax:
Mailing address:
  • Phone: 925-984-5374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW124055
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: