Organization
LA CLINICA DE LA RAZA, INC.
Active
Other names
Casa del Sol (Ascend Elementary School)
Organization subpart
No
Provider details
NPI number
Authorized official
JANE GARCIA (CHIEF EXECUTIVE OFFICER)
(510) 535-4000
Entity
Organization
Contact information
Practice address
3709 E 12TH ST, OAKLAND, CA 94601-4001
(510) 535-6200
(510) 535-4167
Mailing address
PO BOX 22210, OAKLAND, CA 94623-2210
(510) 535-4000
(510) 535-4189
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TBD
ACBHCS
CA
Enumeration date
11/16/2010
Last updated
11/18/2010
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