=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851538409
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHEILA WANG LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2009
-----------------------------------------------------
Last Update Date | 02/11/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 870 SEAVIEW DR
-----------------------------------------------------
City | EL CERRITO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94530-3009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-525-5884
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 870 SEAVIEW DR
-----------------------------------------------------
City | EL CERRITO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94530-3009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 23194
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------