Individual
BREANA WILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1080 MARINA VILLAGE PKWY STE 100, ALAMEDA, CA 94501-1078
(510) 217-2329
Mailing address
1342 LAKESHORE AVE APT 3, OAKLAND, CA 94606-1656
(818) 970-1093
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ACSW89169
CA
1041C0700X
Clinical Social Worker
Primary
108432
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/30/2017
Last updated
05/02/2024
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