Healthcare Provider Details

I. General information

NPI: 1124905138
Provider Name (Legal Business Name): SHAKEARA ONEASHA MATTHEWS ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 CHALLENGER WAY STE 107
SANTA ROSA CA
95407-5423
US

IV. Provider business mailing address

25465 HUNTWOOD AVE
HAYWARD CA
94544-2781
US

V. Phone/Fax

Practice location:
  • Phone: 707-565-4797
  • Fax:
Mailing address:
  • Phone: 650-270-4760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: