Healthcare Provider Details

I. General information

NPI: 1336057686
Provider Name (Legal Business Name): HOPE REIMAGINED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 30TH ST
OAKLAND CA
94609-3307
US

IV. Provider business mailing address

5529 MARSHALL ST
OAKLAND CA
94608-2613
US

V. Phone/Fax

Practice location:
  • Phone: 510-712-2508
  • Fax:
Mailing address:
  • Phone: 510-712-2508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: SUSAN P ANDRIEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 510-712-2508