Provider Demographics
NPI:1679122113
Name:MCMILLAN, ROSALIND DENISE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROSALIND
Middle Name:DENISE
Last Name:MCMILLAN
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 1:7200 BANCROFT AVE STE 176
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2411
Mailing Address - Country:US
Mailing Address - Phone:510-568-2432
Mailing Address - Fax:510-568-3912
Practice Address - Street 1:7200 BANCROFT AVENUE
Practice Address - Street 2:SUITE 176
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2411
Practice Address - Country:US
Practice Address - Phone:510-568-2432
Practice Address - Fax:510-568-3912
Is Sole Proprietor?:No
Enumeration Date:2019-09-07
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW857991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical