Basic Information
Provider Information
NPI: 1134687163
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEELE
FirstName: CAROLINE
MiddleName: JANE
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ROBBINS
OtherFirstName: KAROLINE
OtherMiddleName: JANE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 1998 SAN ANTONIO AVE
Address2:  
City: BERKELEY
State: CA
PostalCode: 947071620
CountryCode: US
TelephoneNumber: 5104737518
FaxNumber: 5107462810
Practice Location
Address1: 401 ROLAND WAY STE 100
Address2:  
City: OAKLAND
State: CA
PostalCode: 946212034
CountryCode: US
TelephoneNumber: 5107462800
FaxNumber: 5107462810
Other Information
ProviderEnumerationDate: 03/08/2019
LastUpdateDate: 03/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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