Healthcare Provider Details

I. General information

NPI: 1215847025
Provider Name (Legal Business Name): COURTNEY JOELLE CEREFICE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 3RD ST
ALAMEDA CA
94501-1851
US

IV. Provider business mailing address

1900 3RD ST
ALAMEDA CA
94501-1851
US

V. Phone/Fax

Practice location:
  • Phone: 510-995-4300
  • Fax:
Mailing address:
  • Phone: 510-995-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number260087557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: