Provider Demographics
NPI:1750629218
Name:HIRSCH, EMILY TEIKEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:TEIKEN
Last Name:HIRSCH
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 1:5957 KEITH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1545
Mailing Address - Country:US
Mailing Address - Phone:415-518-0012
Mailing Address - Fax:
Practice Address - Street 1:5957 KEITH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1545
Practice Address - Country:US
Practice Address - Phone:415-518-0012
Practice Address - Fax:510-338-3459
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 275631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical