Healthcare Provider Details

I. General information

NPI: 1720141674
Provider Name (Legal Business Name): ALLIANT EDUCATIONAL FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 BROADWAY STE 610
OAKLAND CA
94612-2026
US

IV. Provider business mailing address

1440 BROADWAY STE 610
OAKLAND CA
94612-2026
US

V. Phone/Fax

Practice location:
  • Phone: 510-628-9065
  • Fax: 510-628-9068
Mailing address:
  • Phone: 510-628-9065
  • Fax: 510-628-9068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number140000233
License Number StateCA

VIII. Authorized Official

Name: DR. HASSE LEONARD-PAGEL
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 510-628-9065