Healthcare Provider Details

I. General information

NPI: 1902129083
Provider Name (Legal Business Name): ANNA ALBUQUERQUE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 JEFFERSON ST
OAKLAND CA
94612-1215
US

IV. Provider business mailing address

150 GRAND AVE FL 2
OAKLAND CA
94612-3781
US

V. Phone/Fax

Practice location:
  • Phone: 510-923-1099
  • Fax: 510-647-9408
Mailing address:
  • Phone: 510-899-7445
  • Fax: 510-647-9408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number129846
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number129846
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: