Provider Demographics
NPI:1376730622
Name:BLACKSHAW, AMY ELIZABETH (MSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:ELIZABETH
Last Name:BLACKSHAW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2648 INTERNATIONAL BLVD
Mailing Address - Street 2:BRIGHTER BEGINNINGS
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-1506
Mailing Address - Country:US
Mailing Address - Phone:510-903-7530
Mailing Address - Fax:510-437-8955
Practice Address - Street 1:2648 INTERNATIONAL BLVD
Practice Address - Street 2:BRIGHTER BEGINNINGS
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-1506
Practice Address - Country:US
Practice Address - Phone:510-903-7530
Practice Address - Fax:510-437-8955
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker