Healthcare Provider Details

I. General information

NPI: 1740621119
Provider Name (Legal Business Name): ROSANNA FRANKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 07/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 BROADWAY SUITE 610
OAKLAND CA
94612-2041
US

IV. Provider business mailing address

1057 1/2 SAN ANTONIO AVE
ALAMEDA CA
94501-3963
US

V. Phone/Fax

Practice location:
  • Phone: 510-628-9070
  • 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:
Title or Position:
Credential:
Phone: