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General NPI Number Information
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NPI Number | 1093557332
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Entity Type | Individual
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Provider Name | CHARLOTTE ROCK
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Gender | Female
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Dates
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Enumeration Date | 06/08/2024
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 3001 INTERNATIONAL BLVD
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City | OAKLAND
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State | CA
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Zip | 94601-2203
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Country | US
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Telephone | 510-433-8600
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Fax | 510-601-3913
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Provider Business Mailing Address
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Address Line | 3028 COLBY ST APT E
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City | BERKELEY
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State | CA
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Zip | 94705-2045
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Country | US
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Telephone | 530-902-7203
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 131757
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License Number State | CA
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