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NPI Code Detail

MEDICARE: ALEXANDRIA DILLIN WRIGHT LCSW

MEDICARE: ALEXANDRIA DILLIN WRIGHT 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 Worker70802CA

General Provider Information

NPI Number : 1154672491
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRIA DILLIN WRIGHT LCSW
Provider Business Mailing Address
First Line : 552 CROFTON AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94610-1519
Country : US
Telephone Number : 510-697-6923
Fax Number :
Provider Business Practice Location Address
First Line : 2915 MARTIN LUTHER KING JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94703-2133
Country : US
Telephone Number : 510-736-3831
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2012
Last Update Date : 04/10/2018

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