Provider Demographics
NPI:1043442999
Name:HARRISON, JAPERA AKILAH
Entity Type:Individual
Prefix:
First Name:JAPERA
Middle Name:AKILAH
Last Name:HARRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JAPERA
Other - Middle Name:
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2086 COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4902
Mailing Address - Country:US
Mailing Address - Phone:925-827-0212
Mailing Address - Fax:925-827-1122
Practice Address - Street 1:20200 REDWOOD RD STE 15
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4355
Practice Address - Country:US
Practice Address - Phone:510-519-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA808341041C0700X
CA804341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker