Organization
CAL-PEP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA LOCKETT (EXECUTIVE DIRECTOR)
(510) 874-7850
Entity
Organization
Contact information
Practice address
1504 FRANKLIN ST, 302, OAKLAND, CA 94612-2819
(510) 874-7850
Mailing address
PO BOX 71629, OAKLAND, CA 94612-7829
(510) 874-7850
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
Other
Enumeration date
11/06/2008
Last updated
11/06/2008
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