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NPI Code Detail

MEDICARE: NAKIA LINZIESHAVERS LCSW

MEDICARE:   NAKIA  LINZIESHAVERS  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
1103TC1900XCounseling Psychologist
21041C0700XClinical Social Worker88491CA

General Provider Information

NPI Number : 1437713765
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAKIA LINZIESHAVERS LCSW
Provider Business Mailing Address
First Line : PO BOX 71384
Second Line :
City : OAKLAND
State : CA
Zip : 94612-7584
Country : US
Telephone Number : 510-593-8988
Fax Number :
Provider Business Practice Location Address
First Line : 3200 SACRAMENTO ST
Second Line :
City : BERKELEY
State : CA
Zip : 94702-2726
Country : US
Telephone Number : 510-778-6006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2019
Last Update Date : 05/03/2024

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Directions to “ NAKIA LINZIESHAVERS LCSW” Practice Location

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