Healthcare Provider Details

I. General information

NPI: 1164730552
Provider Name (Legal Business Name): ALTERNATIVE FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 09/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MYRTLE ST STE 102
OAKLAND CA
94607-2535
US

IV. Provider business mailing address

111 MYRTLE ST STE 102
OAKLAND CA
94607-2535
US

V. Phone/Fax

Practice location:
  • Phone: 510-839-3800
  • Fax:
Mailing address:
  • Phone: 510-839-3800
  • Fax: 510-839-3888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License NumberPSB 34997
License Number StateCA

VIII. Authorized Official

Name: JAY BERLIN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 510-839-3888