Provider Demographics
NPI:1891205027
Name:CAGE-WATSON, RENEE L (LCSW, MSW)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:L
Last Name:CAGE-WATSON
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:CAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 30342
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94604-6442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:933 MACARTHUR BLVD # 1A
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-3062
Practice Address - Country:US
Practice Address - Phone:510-353-3882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA797341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical