Healthcare Provider Details

I. General information

NPI: 1427635960
Provider Name (Legal Business Name): AILA HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 SHATTUCK AVE STE 1300
BERKELEY CA
94704-1347
US

IV. Provider business mailing address

PO BOX 3499
OAKLAND CA
94609-0499
US

V. Phone/Fax

Practice location:
  • Phone: 415-612-3180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: RORY STANTON
Title or Position: FOUNDER AND CEO
Credential:
Phone: 415-480-1638