Healthcare Provider Details

I. General information

NPI: 1104109883
Provider Name (Legal Business Name): ERIK BROMBERG LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3007 TELEGRAPH AVE STE J
OAKLAND CA
94609-3205
US

IV. Provider business mailing address

3007 TOMPKINS AVE SUITE J
OAKLAND CA
94609
US

V. Phone/Fax

Practice location:
  • Phone: 510-255-0090
  • Fax:
Mailing address:
  • Phone: 510-255-0090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number77067
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: