Organization
CAL PEP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLORIA LOCKETT (EXECUTIVE DIRECTOR)
(510) 874-7850
Entity
Organization
Contact information
Practice address
2811 ADELINE ST, OAKLAND, CA 94608-4409
(510) 874-7850
Mailing address
2811 ADELINE ST, OAKLAND, CA 94608-4409
(510) 874-7850
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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