Provider Demographics
NPI:1790914406
Name:HAILE, EVA (MSW)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:HAILE
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 1:377 LENOX AVE
Mailing Address - Street 2:APT. 41
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4662
Mailing Address - Country:US
Mailing Address - Phone:404-281-6387
Mailing Address - Fax:
Practice Address - Street 1:1855 OLYMPIC BLVD
Practice Address - Street 2:SUITE 225
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5089
Practice Address - Country:US
Practice Address - Phone:925-933-2627
Practice Address - Fax:925-933-5824
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical