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General NPI Number Information
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NPI Number | 1073265278
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Entity Type | Organization
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Legal Business Name | ATHMINDSET LLC
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 1104 MARIANAS LN
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City | ALAMEDA
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State | CA
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Zip | 94502-6831
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Country | US
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Telephone | 510-206-6095
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Fax |
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Provider Business Mailing Address
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Address Line | 875 ISLAND DR STE A
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City | ALAMEDA
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State | CA
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Zip | 94502-6700
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Country | US
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Telephone | 510-206-6095
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | ARON SUMII
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Credential | MFT
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Telephone | 510-206-6095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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