Provider Demographics
NPI:1669610846
Name:WILKINSON, ELIZABETH ANGIE
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:ANGIE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 9TH ST
Mailing Address - Street 2:APT. B
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-3604
Mailing Address - Country:US
Mailing Address - Phone:773-391-0099
Mailing Address - Fax:
Practice Address - Street 1:101 15TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-5103
Practice Address - Country:US
Practice Address - Phone:415-682-3276
Practice Address - Fax:415-865-3090
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker