Provider Demographics
NPI:1396893574
Name:WASHINGTON, ALICE ROCHELLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:ROCHELLE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 HOWE ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5211
Mailing Address - Country:US
Mailing Address - Phone:510-384-0375
Mailing Address - Fax:510-482-9238
Practice Address - Street 1:4003 HOWE ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5211
Practice Address - Country:US
Practice Address - Phone:510-384-0375
Practice Address - Fax:510-482-9238
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 15625104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker