Provider Demographics
NPI:1447084231
Name:MILLSPAUGH, CASSANDRA (AMFT)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:MILLSPAUGH
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 ELM ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3012
Mailing Address - Country:US
Mailing Address - Phone:510-459-0466
Mailing Address - Fax:510-594-2588
Practice Address - Street 1:3300 ELM ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3012
Practice Address - Country:US
Practice Address - Phone:510-459-0466
Practice Address - Fax:510-594-2588
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT149139106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist