Organization
CIVICORPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TESSA NICHOLAS (EXECUTIVE DIRECTOR)
(510) 992-7853
Entity
Organization
Contact information
Practice address
101 MYRTLE ST, OAKLAND, CA 94607-2543
(510) 992-7800
Mailing address
101 MYRTLE ST, OAKLAND, CA 94607-2543
(510) 992-7800
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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