Provider Demographics
NPI:1851501381
Name:MATZ, SHEILA LYNN (ASW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:LYNN
Last Name:MATZ
Suffix:
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 1:7200 BANCROFT AVE STE 125D
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2415
Mailing Address - Country:US
Mailing Address - Phone:510-777-3878
Mailing Address - Fax:510-777-3880
Practice Address - Street 1:7200 BANCROFT AVENUE ,SUITE 125D
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2415
Practice Address - Country:US
Practice Address - Phone:510-777-3878
Practice Address - Fax:510-777-3880
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 20131104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker