# WESTCOAST CHILDREN'S CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366870388
- **Authorized official:** SUSAN DRAGER (TAYS PROGRAM DIRECTOR)
- **Authorized official phone:** (510) 269-9157

## Contact information

- **Practice address:** 3301 E 12TH ST, SUITE 259, OAKLAND, CA 94601-3424
- **Practice address phone:** (510) 269-9157
- **Mailing address:** 3301 E 12TH ST, SUITE 259, OAKLAND, CA 94601-3424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 10/30/2013
- **Last updated:** 10/30/2013