Individual
AZALEAH GOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APCC
Contact information
Practice address
2903 SACRAMENTO ST, BERKELEY, CA 94702-2509
(510) 269-7726
Mailing address
490 LAKE PARK AVE UNIT 10694, OAKLAND, CA 94610-8025
(510) 269-7726
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APCC11952
CA
101YM0800X
Mental Health Counselor
Primary
APCC11952
CA
101YP2500X
Professional Counselor
APCC11952
CA
Other
Enumeration date
08/20/2021
Last updated
04/21/2026
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