Healthcare Provider Details

I. General information

NPI: 1669785366
Provider Name (Legal Business Name): JAMILA A MCCRADY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4368 LINCOLN AVE
OAKLAND CA
94602-2529
US

IV. Provider business mailing address

455 HUNTER AVE
OAKLAND CA
94603-2135
US

V. Phone/Fax

Practice location:
  • Phone: 510-531-3111
  • Fax: 510-530-8083
Mailing address:
  • Phone: 510-827-8408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: