Healthcare Provider Details

I. General information

NPI: 1104787779
Provider Name (Legal Business Name): GOOD HEALTH FAMILY HEALING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 38TH AVE
OAKLAND CA
94619-1003
US

IV. Provider business mailing address

2605 38TH AVE
OAKLAND CA
94619-1003
US

V. Phone/Fax

Practice location:
  • Phone: 415-244-7901
  • Fax:
Mailing address:
  • Phone: 415-244-7901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAYVON MUHAMMAD
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LM
Phone: 415-244-7901