Provider Demographics
NPI:1134603426
Name:KAIN, SUANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUANNE
Middle Name:
Last Name:KAIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SUZY
Other - Middle Name:
Other - Last Name:KAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3333 BRUNELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602
Mailing Address - Country:US
Mailing Address - Phone:310-614-0917
Mailing Address - Fax:
Practice Address - Street 1:559 16TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1515
Practice Address - Country:US
Practice Address - Phone:510-613-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA1038181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor