Provider Demographics
NPI:1457540353
Name:WHITE-SOSO, FREDERICKA L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:FREDERICKA
Middle Name:L
Last Name:WHITE-SOSO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:RICKA
Other - Middle Name:L
Other - Last Name:WHITE-SOSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 10092
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-0092
Mailing Address - Country:US
Mailing Address - Phone:510-496-3475
Mailing Address - Fax:
Practice Address - Street 1:562 14TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1443
Practice Address - Country:US
Practice Address - Phone:510-496-3475
Practice Address - Fax:510-496-3476
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA265681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical