Healthcare Provider Details

I. General information

NPI: 1497945265
Provider Name (Legal Business Name): YAEL STILES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 08/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8750 MOUNTAIN BLVD BLDG 69
OAKLAND CA
94605-4500
US

IV. Provider business mailing address

2275 ARLINGTON DR
SAN LEANDRO CA
94578-1132
US

V. Phone/Fax

Practice location:
  • Phone: 510-777-5300
  • Fax: 510-317-1144
Mailing address:
  • Phone: 510-777-5300
  • Fax: 510-317-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: