Organization
WESTCOAST CHILDREN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN DRAGER (TAYS PROGRAM DIRECTOR)
(510) 269-9157
Entity
Organization
Contact information
Practice address
3301 E 12TH ST, SUITE 259, OAKLAND, CA 94601-3424
(510) 269-9157
Mailing address
3301 E 12TH ST, SUITE 259, OAKLAND, CA 94601-3424
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/30/2013
Last updated
10/30/2013
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