Healthcare Provider Details

I. General information

NPI: 1881632867
Provider Name (Legal Business Name): COUNTY OF ALAMEDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

384 14TH ST
OAKLAND CA
94612-3211
US

IV. Provider business mailing address

1404 FRANKLIN ST STE 200
OAKLAND CA
94612-3208
US

V. Phone/Fax

Practice location:
  • Phone: 510-891-8950
  • Fax: 510-273-3802
Mailing address:
  • Phone: 510-891-8950
  • Fax: 510-273-3802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DAVID WILLIAM MODERSBACH
Title or Position: GRANTS MGR AO
Credential:
Phone: 510-891-8916