Provider Demographics
NPI:1871957639
Name:PAULOS, JOSHUA (LCSW96230)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:PAULOS
Suffix:
Gender:M
Credentials:LCSW96230
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501
Mailing Address - Country:US
Mailing Address - Phone:510-318-6100
Mailing Address - Fax:510-830-3318
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:510-318-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW962301041C0700X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical