Individual
AMANDA MIYEKO WAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5275 CLAREMONT AVE, OAKLAND, CA 94618-1032
(510) 701-8849
(510) 601-3913
Mailing address
522 ALBEMARLE ST, EL CERRITO, CA 94530-3215
(510) 919-5861
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/14/2016
Last updated
07/06/2021
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