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General NPI Number Information
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NPI Number | 1104035153
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Entity Type | Individual
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Provider Name | SARAH WEST CARSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 1266 14TH ST
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City | OAKLAND
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State | CA
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Zip | 94607-2205
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Country | US
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Telephone | 510-273-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 626 58TH ST
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City | OAKLAND
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State | CA
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Zip | 94609-1412
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Country | US
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Telephone | 415-407-5130
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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 | 214238
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 28236
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License Number State | CA
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