Provider Demographics
NPI:1891194262
Name:PERKINS, DEANA (SUDCCIII-CS, CCDS)
Entity Type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:SUDCCIII-CS, CCDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 ANDOVER ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2817
Mailing Address - Country:US
Mailing Address - Phone:510-547-1531
Mailing Address - Fax:510-547-1543
Practice Address - Street 1:3408 ANDOVER ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2817
Practice Address - Country:US
Practice Address - Phone:510-547-1531
Practice Address - Fax:510-547-1543
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7100101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)