Healthcare Provider Details

I. General information

NPI: 1861527202
Provider Name (Legal Business Name): DEANNA MARIE BERNARD MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 40TH ST
OAKLAND CA
94609-2633
US

IV. Provider business mailing address

2275 ARLINGTON DR.
SAN LEANDRO CA
94578
US

V. Phone/Fax

Practice location:
  • Phone: 510-653-5040
  • Fax: 510-653-6475
Mailing address:
  • Phone: 510-317-1437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW #26476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: