Provider Demographics
NPI:1043469844
Name:DAVIS, SAMUEL ARIAS (ACSW)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:ARIAS
Last Name:DAVIS
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 EMBARCADERO
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-5334
Mailing Address - Country:US
Mailing Address - Phone:510-567-8100
Mailing Address - Fax:
Practice Address - Street 1:2000 EMBARCADERO
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-5334
Practice Address - Country:US
Practice Address - Phone:510-567-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 20838104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker