Healthcare Provider Details

I. General information

NPI: 1538418033
Provider Name (Legal Business Name): ALLIANT INTERNATIONAL UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2012
Last Update Date: 08/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 66TH AVE
OAKLAND CA
94621-3506
US

IV. Provider business mailing address

1440 BROADWAY STE 610
OAKLAND CA
94612-2026
US

V. Phone/Fax

Practice location:
  • Phone: 510-639-3214
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: DR. ELIZABETH MILNES
Title or Position: EXECUTIVE DIRECTOR
Credential: PSY.D.
Phone: 510-628-9065