Healthcare Provider Details

I. General information

NPI: 1285519470
Provider Name (Legal Business Name): ALMA SHARISE BUENAVISTA MSW,PPSC,ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 54TH ST
OAKLAND CA
94608-3142
US

IV. Provider business mailing address

915 54TH ST RM 5
OAKLAND CA
94608-3142
US

V. Phone/Fax

Practice location:
  • Phone: 510-846-4252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberASW132229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: