Individual ProviderKyalai A ShawCounselorBehavioral Health & Social Service ProvidersPractice Address3845 Telegraph Ave, Oakland, CA 94609-2419(510) 450-1197(510) 268-8120PECOS EnrollmentBased on the most recent information from CMS, provider Kyalai A Shaw does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1386312783Provider TypeIndividualFull NameShaw, Kyalai ATitleMissCredentialSUDRCGenderFemaleSole ProprietorNoEnumeration Date8/31/2021Last Updated4/26/2024Contact InformationPractice LocationPractice Address3845 Telegraph Ave, Oakland, CA 94609-2419Phone(510) 450-1197FaxUnlisted FaxMailing LocationMailing Address1200 Concord Ave Ste Concord, Concord, CA 94520-4915Phone(510) 268-8120FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YA0400XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense16183CaliforniaCode106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseRBT-20-142531California