Healthcare Provider Details

I. General information

NPI: 1760271753
Provider Name (Legal Business Name): THE JUJU FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31277 MEADOWBROOK AVE
HAYWARD CA
94544-7549
US

IV. Provider business mailing address

31277 MEADOWBROOK AVE
HAYWARD CA
94544-7549
US

V. Phone/Fax

Practice location:
  • Phone: 510-598-9137
  • Fax:
Mailing address:
  • Phone: 510-598-9137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL GARCIA-PICAZO
Title or Position: EXECUTIVE DIRECTOR
Credential: C.H.W
Phone: 510-598-9137