Healthcare Provider Details

I. General information

NPI: 1952579062
Provider Name (Legal Business Name): MS. ANKE AL-BATAINEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREL DAVERN-FECKER

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6925 CHABOT RD
OAKLAND CA
94618-1921
US

IV. Provider business mailing address

2275 ARLINGTON DR
SAN LEANDRO CA
94578-1132
US

V. Phone/Fax

Practice location:
  • Phone: 510-601-6497
  • Fax:
Mailing address:
  • Phone: 510-481-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: