Provider Demographics
NPI:1023134632
Name:SADIQ, RENEE DEANNA (LCSW)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:DEANNA
Last Name:SADIQ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 EAST 33RD ST
Mailing Address - Street 2:#4
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4059
Mailing Address - Country:US
Mailing Address - Phone:510-534-7339
Mailing Address - Fax:
Practice Address - Street 1:7200 BANCROFT AVE
Practice Address - Street 2:STE 125D
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605
Practice Address - Country:US
Practice Address - Phone:510-777-3889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 180351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical