Healthcare Provider Details

I. General information

NPI: 1679522627
Provider Name (Legal Business Name): THE WEST OAKLAND HEALTH COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 ADELINE ST
OAKLAND CA
94607-2608
US

IV. Provider business mailing address

700 ADELINE ST
OAKLAND CA
94607-2608
US

V. Phone/Fax

Practice location:
  • Phone: 510-835-9610
  • Fax: 510-272-0209
Mailing address:
  • Phone: 510-835-9610
  • Fax: 510-272-0209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ROBERT PHILLIPS
Title or Position: CEO
Credential:
Phone: 510-835-9610