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EBONY GREEN
NPI 1710729801
Peer Specialist in Oakland, CA

Active since June 10, 2024
3800 COOLIDGE AVE, OAKLAND, CA 94602(510) 482-2244 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 23, 2025, Nov 12, 2024, Jun 10, 2024 (3 updates tracked since 2024).

About Ebony Green NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EBONY GREEN (NPI 1710729801) is an individual peer specialist in Oakland, California, licensed in California (MPSS-DEGOQU) and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1710729801
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameEBONY GREEN
Location Address3800 COOLIDGE AVEOakland, CA 94602-3311
Mailing Address4712 Foothill BlvdOakland, CA 94601-5350 · (603) 339-6632
Phone(510) 482-2244
Sole ProprietorNo
Enumeration DateJune 10, 2024
Last NPPES UpdateJune 23, 20253 updates tracked since enumeration
NPPES CertifiedJune 23, 2025
✔ NPI 1710729801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in CA · MPSS-DEGOQU
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedCommunity Health WorkerTaxonomy 172V00000X
3800 COOLIDGE AVE, Oakland, CA 94602
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY ELLEN ROJAS
Marriage & Family Therapist
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
KAYLA JOANNE DOUGLAS
Student in an Organized Health Care Education/Training Program
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
MICHAELLA HELENA DEAN
Marriage & Family Therapist
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
FRED FINCH YOUTH & FAMILY SERVICES
Adult Companion
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
MR. ROGER WAYNE DANIELS LCSW
Social Worker (Clinical)
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
MS. ALEXIS V. LOWENSTEIN LMFT
Marriage & Family Therapist
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
KENDRA SUNYUNG STAFFORD ROBINSON LMFT
Marriage & Family Therapist
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
MISS MARY KATHERINE COPE MFT
Counselor (Mental Health)
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 773-9629

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebony Green's NPI number?

The NPI number for Ebony Green is 1710729801. It was assigned to this individual provider in the NPPES registry on June 10, 2024.

Where is Ebony Green located?

Ebony Green practices at 3800 Coolidge Ave, Oakland, CA 94602. The listed phone number is (510) 482-2244.

What is Ebony Green's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Ebony Green was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.