Healthcare Provider Details

I. General information

NPI: 1811282833
Provider Name (Legal Business Name): RINA BREAKSTONE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 04/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 14TH ST
OAKLAND CA
94612-3211
US

IV. Provider business mailing address

1385 MISSION ST SUITE 240
SAN FRANCISCO CA
94103-2623
US

V. Phone/Fax

Practice location:
  • Phone: 510-365-4379
  • Fax:
Mailing address:
  • Phone: 415-864-4002
  • Fax: 415-864-7093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number88320
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: