Provider Demographics
NPI:1396025680
Name:SAMPAIO, SANDRA MALTEZ (MSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MALTEZ
Last Name:SAMPAIO
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 1:3800 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3311
Mailing Address - Country:US
Mailing Address - Phone:510-506-0157
Mailing Address - Fax:
Practice Address - Street 1:2523 EL PORTAL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3305
Practice Address - Country:US
Practice Address - Phone:510-439-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA719081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical