Provider Demographics
NPI:1922384379
Name:SOCIAL Q
Entity Type:Organization
Organization Name:SOCIAL Q
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTISM SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-541-6307
Mailing Address - Street 1:248 3RD STREET
Mailing Address - Street 2:SUITE 723
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2335
Mailing Address - Country:US
Mailing Address - Phone:510-541-6307
Mailing Address - Fax:
Practice Address - Street 1:438 W GRAND AVE APT 608
Practice Address - Street 2:UNIT 608
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2335
Practice Address - Country:US
Practice Address - Phone:510-541-6307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency