Provider Demographics
NPI:1831300250
Name:KILMER, JANE II (ASW)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:KILMER
Suffix:II
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1358
Mailing Address - Country:US
Mailing Address - Phone:510-893-9230
Mailing Address - Fax:510-893-2074
Practice Address - Street 1:1727 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:SUITE 109
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1358
Practice Address - Country:US
Practice Address - Phone:510-893-9230
Practice Address - Fax:510-893-2074
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 213611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical