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NPI Code Detail

MEDICARE: AMANDA KATE HERRERA LCSW

MEDICARE: AMANDA KATE HERRERA 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 WorkerLCSW64877CA

General Provider Information

NPI Number : 1164673828
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA KATE HERRERA LCSW
Provider Business Mailing Address
First Line : 21455 BIRCH ST # 201
Second Line :
City : HAYWARD
State : CA
Zip : 94541-2165
Country : US
Telephone Number : 510-926-9391
Fax Number :
Provider Business Practice Location Address
First Line : 2828 FORD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2114
Country : US
Telephone Number : 510-926-9391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2008
Last Update Date : 11/20/2024

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