Organization
HEALTH CARE FOR THE HOMELESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OTERIA RANDALL KOAYEN FNP (CLINICIAN)
(510) 532-1930
Entity
Organization
Contact information
Practice address
1900 FRUITVALE AVE, OAKLAND, CA 94601-2464
(510) 532-1930
Mailing address
1166 BROOKTRAIL DR, PITTSBURG, CA 94565-7627
(925) 562-9335
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
439624
CA
Other
Enumeration date
01/19/2007
Last updated
08/22/2020
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