MEDICARE: MS. ANDREA LEIGH SELINER

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1396938387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDREA LEIGH SELINER

Provider Business Mailing Address
First Line	:	525 21ST ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-1605
Country	:	US
Telephone Number	:	415-531-1639
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 21ST ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-1605
Country	:	US
Telephone Number	:	415-531-1639
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	06/24/2026

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