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NPI Code Detail

MEDICARE: SUSAN SUGARMAN LCSW

MEDICARE:   SUSAN  SUGARMAN  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCS18826CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053384677
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN SUGARMAN LCSW
Provider Business Mailing Address
First Line : 1200 SUNNYHILLS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94610-1818
Country : US
Telephone Number : 510-206-9746
Fax Number :
Provider Business Practice Location Address
First Line : 4283 PIEDMONT AVE
Second Line : SUITE E6
City : OAKLAND
State : CA
Zip : 94611-4758
Country : US
Telephone Number : 510-206-9746
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 01/08/2010

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Directions to “ SUSAN SUGARMAN LCSW” Practice Location

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