Provider Demographics
NPI:1386412492
Name:BRASHEM, ANNIE (LCSW)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:BRASHEM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:BERENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5250 LEONA ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-3004
Mailing Address - Country:US
Mailing Address - Phone:510-545-3837
Mailing Address - Fax:
Practice Address - Street 1:5250 LEONA ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-3004
Practice Address - Country:US
Practice Address - Phone:510-545-3837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health