Organization
FRED FINCH YOUTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS N ALEXANDER LCSW (PRESIDENT AND CEO)
(510) 482-2244
Entity
Organization
Contact information
Practice address
3800 COOLIDGE AVE, OAKLAND, CA 94602-3311
(510) 482-2244
(510) 488-1960
Mailing address
3800 COOLIDGE AVE, OAKLAND, CA 94602-3311
(510) 482-2244
(510) 488-1960
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00113
LEGAL ENTITY NUMBER
CA
01
—
00G503291
PROVIDER ID
CA
05
—
01260208
—
CA
05
—
01761908
—
CA
05
—
01870808
—
CA
Enumeration date
12/14/2006
Last updated
07/28/2022
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