Healthcare Provider Details

I. General information

NPI: 1760181283
Provider Name (Legal Business Name): 1 DIRECTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 BROADWAY
OAKLAND CA
94611-4612
US

IV. Provider business mailing address

12523 LIMONITE AVE STE 440-192
EASTVALE CA
91752-3665
US

V. Phone/Fax

Practice location:
  • Phone: 510-704-3509
  • Fax:
Mailing address:
  • Phone: 510-815-5108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RODERICK FIGGS
Title or Position: CEO
Credential: MA
Phone: 510-815-5108