Healthcare Provider Details

I. General information

NPI: 1679787360
Provider Name (Legal Business Name): FAMILY BRIDGES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1388 HARRISON STREET
OAKLAND CA
94612
US

IV. Provider business mailing address

168 11TH STREET
OAKLAND CA
94607
US

V. Phone/Fax

Practice location:
  • Phone: 510-302-0460
  • Fax: 510-302-0466
Mailing address:
  • Phone: 510-839-2022
  • Fax: 510-839-2435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTINE SUSAN JAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: RD
Phone: 510-839-2270