Healthcare Provider Details

I. General information

NPI: 1386771475
Provider Name (Legal Business Name): LAURIE LOBER LCSW, BCD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 LAKESHORE AVE SUITE B
OAKLAND CA
94606-1187
US

IV. Provider business mailing address

2100 LAKESHORE AVE SUITE B
OAKLAND CA
94606-1187
US

V. Phone/Fax

Practice location:
  • Phone: 510-763-7992
  • Fax: 510-655-3379
Mailing address:
  • Phone: 510-763-7992
  • Fax: 510-655-3379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS10468
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: