Mcdougal, Audrey

Mcdougal, Audrey is an individual health care provider with primary practice located at 400 Estudillo Ave Ste 100 , San Leandro CA 94577-4962. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Mcdougal, Audrey can be contacted via phone (510) 352-9200.

Contact Information

Primary practice address
400 Estudillo Ave Ste 100 San Leandro CA 94577-4962
Phone: (510) 352-9200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X ASW87597 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW106518 California

Profile Details

NPI number 1811236417
LBN Legal business name Mcdougal, Audrey
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 4th, 2013
Last updated Jun 10th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811236417 NPPES
Massachusetts MEDICAID 1300881

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