Healthcare Provider Details
I. General information
NPI: 1558540971
Provider Name (Legal Business Name): RACHEL BAYARD COOKS M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9925 INTERNATIONAL BLVD
OAKLAND CA
94603-2558
US
IV. Provider business mailing address
9925 INTERNATIONAL BLVD
OAKLAND CA
94603-2558
US
V. Phone/Fax
- Phone: 510-562-3731
- Fax:
- Phone: 510-562-3731
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: