Healthcare Provider Details

I. General information

NPI: 1942844303
Provider Name (Legal Business Name): MRS. RACHELE KRISTINE GEBRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2019
Last Update Date: 05/13/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 INTERNATIONAL BLVD
OAKLAND CA
94601-2203
US

IV. Provider business mailing address

3001 INTERNATIONAL BLVD
OAKLAND CA
94601-2203
US

V. Phone/Fax

Practice location:
  • Phone: 510-433-8600
  • Fax:
Mailing address:
  • Phone: 707-490-0882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: