Healthcare Provider Details

I. General information

NPI: 1134984826
Provider Name (Legal Business Name): FAMILY CARE TRANSPORTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 FRANKLIN ST STE 300
OAKLAND CA
94607-3734
US

IV. Provider business mailing address

215 W MACARTHUR BLVD APT 249
OAKLAND CA
94611-5307
US

V. Phone/Fax

Practice location:
  • Phone: 510-616-8942
  • Fax:
Mailing address:
  • Phone: 510-219-6050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: TARIKU TESFAYE KEBEDE
Title or Position: PRESIDENT
Credential:
Phone: 510-616-8942