Provider Demographics
NPI:1467684795
Name:KAFELE, DAJENYA SHOSHANNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DAJENYA
Middle Name:SHOSHANNA
Last Name:KAFELE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 HILLTOP MALL RD
Mailing Address - Street 2:SUITE 41
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-1921
Mailing Address - Country:US
Mailing Address - Phone:510-672-0772
Mailing Address - Fax:
Practice Address - Street 1:3150 HILLTOP MALL RD
Practice Address - Street 2:SUITE 41
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-1921
Practice Address - Country:US
Practice Address - Phone:510-672-0772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 23043104100000X
CA277151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker