Healthcare Provider Details

I. General information

NPI: 1629787486
Provider Name (Legal Business Name): ADRIANA BARBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 BANCROFT AVE STE 125D
OAKLAND CA
94605-2424
US

IV. Provider business mailing address

7200 BANCROFT AVE STE 125D
OAKLAND CA
94605-2424
US

V. Phone/Fax

Practice location:
  • Phone: 510-777-3870
  • Fax:
Mailing address:
  • Phone: 510-777-3870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number99784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: