Provider Demographics
NPI:1124492855
Name:KAMANZI, ASSUMPTA KYABARUNGU (ASW)
Entity type:Individual
Prefix:
First Name:ASSUMPTA
Middle Name:KYABARUNGU
Last Name:KAMANZI
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:KYABARUNGU
Other - Middle Name:ASSUMPTA
Other - Last Name:KAMANZI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3511 PATRIOT CT
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-7027
Mailing Address - Country:US
Mailing Address - Phone:925-623-3144
Mailing Address - Fax:
Practice Address - Street 1:1410 DANZIG PLZ
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-7979
Practice Address - Country:US
Practice Address - Phone:925-260-0512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical