MEDICARE: HERBERT GERALD SINGLETON L.C.S.W.

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	LCS18616	CA

General Provider Information

NPI Number	:	1588682207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERBERT GERALD SINGLETON L.C.S.W.

Provider Business Mailing Address
First Line	:	2579 SAN PABLO AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-1159
Country	:	US
Telephone Number	:	510-446-7100
Fax Number	:	510-446-7191

Provider Business Practice Location Address
First Line	:	2551 SAN PABLO AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-1159
Country	:	US
Telephone Number	:	510-446-7100
Fax Number	:	510-446-7191

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	06/10/2011

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