Provider Demographics
NPI:1063778264
Name:BIRDEN, HAGIKAH VICTORIA
Entity type:Individual
Prefix:
First Name:HAGIKAH
Middle Name:VICTORIA
Last Name:BIRDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 PERKINS ST APT 11
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4717
Mailing Address - Country:US
Mailing Address - Phone:559-885-2273
Mailing Address - Fax:
Practice Address - Street 1:1919 ADDISON ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1141
Practice Address - Country:US
Practice Address - Phone:510-923-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1161191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical