Provider Demographics
NPI:1538465042
Name:WASHINGTON, CHARLES JR (ACSW)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:WASHINGTON
Suffix:JR
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 3RD AVE APT 1403
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-2245
Mailing Address - Country:US
Mailing Address - Phone:510-833-1110
Mailing Address - Fax:
Practice Address - Street 1:1005 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1148
Practice Address - Country:US
Practice Address - Phone:510-977-2852
Practice Address - Fax:510-977-2852
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1094031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical