Basic Information
Provider Information
NPI: 1811282833
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BREAKSTONE
FirstName: RINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1385 MISSION ST
Address2: SUITE 240
City: SAN FRANCISCO
State: CA
PostalCode: 941032623
CountryCode: US
TelephoneNumber: 4158644002
FaxNumber: 4158647093
Practice Location
Address1: 386 14TH ST
Address2:  
City: OAKLAND
State: CA
PostalCode: 946123211
CountryCode: US
TelephoneNumber: 5103654379
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/17/2011
LastUpdateDate: 04/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X88320CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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