MEDICARE: FIRST 5 ALAMEDA COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1467223362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST 5 ALAMEDA COUNTY

Provider Business Mailing Address
First Line	:	1115 ATLANTIC AVE
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1145
Country	:	US
Telephone Number	:	510-227-6900
Fax Number	:	510-227-6901

Provider Business Practice Location Address
First Line	:	1115 ATLANTIC AVE
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1145
Country	:	US
Telephone Number	:	510-227-6900
Fax Number	:	510-227-6901

Authorized Official
Title or Position	:	DEPUTY CEO
Name	:	CALLY MARTIN
Credential	:
Telephone Number	:	510-227-6978

Provider Enumeration Date	:	01/10/2024
Last Update Date	:	01/10/2024

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