Provider Demographics
NPI:1487161618
Name:WARA-GOSS, RUBY (LCSW)
Entity type:Individual
Prefix:MS
First Name:RUBY
Middle Name:
Last Name:WARA-GOSS
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 1:248 3RD ST UNIT 1206
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4375
Mailing Address - Country:US
Mailing Address - Phone:510-327-3201
Mailing Address - Fax:
Practice Address - Street 1:3863 HOWE ST STE D
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5343
Practice Address - Country:US
Practice Address - Phone:510-327-3201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-09
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1016301041C0700X
CA81238101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical