Healthcare Provider Details

I. General information

NPI: 1497954531
Provider Name (Legal Business Name): SENECA CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 WALNUT ST APT 3
ALAMEDA CA
94501-4422
US

IV. Provider business mailing address

1301 WALNUT ST APT 3
ALAMEDA CA
94501-4422
US

V. Phone/Fax

Practice location:
  • Phone: 925-603-1900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY LAMONT NESBITT
Title or Position: COUNSELOR
Credential:
Phone: 510-295-5804