Individual
CHARLENE JIMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
638 21ST ST APT 218, OAKLAND, CA 94612-1890
(510) 927-5180
Mailing address
629 OAKLAND AVE, OAKLAND, CA 94611-4567
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
CICA05010821
CA
Other
Enumeration date
05/25/2016
Last updated
05/06/2024
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