Organization
BAY MTU
Active
Other names
Alameda County CCS
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN L JOHNSON PT (CHIEF THERAPIST)
(510) 267-3278
Entity
Organization
Contact information
Practice address
2001 BOCKMAN RD, BAY SCHOOL, ROOM 25, SAN LORENZO, CA 94580-1903
(510) 317-4355
(510) 278-8246
Mailing address
1000 BROADWAY, 5TH FLOOR, OAKLAND, CA 94607-4099
(510) 267-3278
(510) 268-7110
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
CA
225XP0200X
Pediatric Occupational Therapist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CCS00034F
CCS PROVIDER NUMBER
CA
Enumeration date
01/09/2007
Last updated
09/11/2025
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