Provider Demographics
NPI:1598947988
Name:MASSINGALE, ORLANDO A
Entity Type:Individual
Prefix:MR
First Name:ORLANDO
Middle Name:A
Last Name:MASSINGALE
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ORLANDO
Other - Middle Name:A
Other - Last Name:MASSINGALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1400 CARPENTIER ST APT 326
Mailing Address - Street 2:1400 CARPENTIER ST APT#326
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3657
Mailing Address - Country:US
Mailing Address - Phone:510-644-0200
Mailing Address - Fax:510-644-2044
Practice Address - Street 1:2975 SACRAMENTO ST
Practice Address - Street 2:2975 SACRAMENTO ST
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-2534
Practice Address - Country:US
Practice Address - Phone:510-644-0200
Practice Address - Fax:510-644-2044
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)