Healthcare Provider Details

I. General information

NPI: 1295253854
Provider Name (Legal Business Name): ALLEGRA KATHRYN MILLER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLEGRA KATHRYN HU MSW

II. Dates (important events)

Enumeration Date: 09/05/2017
Last Update Date: 09/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 INTERNATIONAL BLVD
OAKLAND CA
94601-2203
US

IV. Provider business mailing address

590 MERRITT AVE APT 3
OAKLAND CA
94610-5106
US

V. Phone/Fax

Practice location:
  • Phone: 510-433-8600
  • Fax:
Mailing address:
  • Phone: 831-234-7781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: