Healthcare Provider Details

I. General information

NPI: 1083478333
Provider Name (Legal Business Name): CASA ALMA MENTAL HEALTH A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 03/02/2024
Certification Date: 03/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5627 TELEGRAPH AVE # 147
OAKLAND CA
94609-1707
US

IV. Provider business mailing address

5627 TELEGRAPH AVE # 147
OAKLAND CA
94609-1707
US

V. Phone/Fax

Practice location:
  • Phone: 510-306-4677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIANA YBARRA
Title or Position: OWNER
Credential: PSYD
Phone: 510-306-4677