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NPI Code Detail

MEDICARE: CITY OF FREMONT

MEDICARE: CITY OF FREMONT
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1477962686
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY OF FREMONT
Provider Business Mailing Address
First Line : 39155 LIBERTY ST.
Second Line : #E500
City : FREMONT
State : CA
Zip : 94537-5006
Country : US
Telephone Number : 510-574-2100
Fax Number :
Provider Business Practice Location Address
First Line : 36300 FREMONT BLVD
Second Line :
City : FREMONT
State : CA
Zip : 94536-3511
Country : US
Telephone Number : 510-796-1776
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. ANNIE BAILEY
Credential : M.S., M.P.A., LMFT
Telephone Number : 510-574-2100
Provider Enumeration Date : 08/13/2014
Last Update Date : 08/24/2020

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Directions to “CITY OF FREMONT ” Practice Location

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