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Organization
THE PERMANENTE MEDICAL GROUP
Active
Organization
THE PERMANENTE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANA SUKIENNIK-TAKAOKA PH.D. (BEHAVIORAL HEALTH MANAGER II)
(510) 752-1075
Entity
Organization
Contact information
Practice address
3900 BROADWAY, OAKLAND, CA 94611-5693
(510) 752-1075
Mailing address
275 WEST MACARTHUR BLVD., OAKLAND, CA 94611-5693
(510) 752-1075
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PSY 27420
CA
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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