Healthcare Provider Details

I. General information

NPI: 1558610808
Provider Name (Legal Business Name): ASTRA HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2012
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SANTA CLARA AVE 255
OAKLAND CA
94610-1375
US

IV. Provider business mailing address

55 SANTA CLARA AVE 255
OAKLAND CA
94610-1375
US

V. Phone/Fax

Practice location:
  • Phone: 510-272-0777
  • Fax:
Mailing address:
  • Phone: 510-272-0777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM JAMES SHELTON
Title or Position: BOARD OF GOVERNORS
Credential:
Phone: 510-272-0777