Eileen Colorado Licensedclinical Socialworker Professional Corporation

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EILEEN COLORADO LICENSEDCLINICAL SOCIALWORKER PROFESSIONAL CORPORATION

Practice address

1300 Clay St Ste 600
Oakland, CA 94612-1427

Phone

(702) 241-1249

NPI assigned

May 14, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eileen Ellsworth Colorado, LCSW

Title

Owner

Phone

(702) 241-1249

Specialties & licenses 1

Addresses

Other names 1

• Pacific Bay Assessments & Counseling Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557792000000",
    "number": "1669038642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 RIDGE PARK DR",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945181434",
            "telephone_number": "702-241-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CLAY ST STE 600",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121427",
            "telephone_number": "702-241-1249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1067 Ridge Park Dr",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945181434",
            "country_code": "US",
            "telephone_number": "702-241-1249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EILEEN COLORADO LICENSEDCLINICAL SOCIALWORKER PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-14",
        "last_updated": "2019-05-14",
        "status": "A",
        "authorized_official_last_name": "COLORADO",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "ELLSWORTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-241-1249",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Bay Assessments & Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dena Ehrlich
• Sophie Ehrlich
• Devin Ehrlichman, DPT
• Bahia Ehsan, MS
• Elizabeth Eichmann
• Leah Eisbart
• Molly Oshea Eiseman, MS CCC-SLP
• Eric O. Eisemon, MD
• Amy Christine Eisenberg, DO
• Emily Eisenberg, PA-C

• Clinical Social Worker in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.