Healthcare Provider Details

I. General information

NPI: 1437496973
Provider Name (Legal Business Name): COMMUNITY HEALTH FOR ASIAN AMERICANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 MACARTHUR BLVD
OAKLAND CA
94610-3930
US

IV. Provider business mailing address

268 GRAND AVE
OAKLAND CA
94610-4724
US

V. Phone/Fax

Practice location:
  • Phone: 510-879-3040
  • Fax: 510-879-3049
Mailing address:
  • Phone: 510-835-2777
  • Fax: 510-835-0164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KENNETH KIM
Title or Position: DIRECTOR OF CLINICAL SERVICES AND O
Credential: PSYD
Phone: 510-835-2777