Healthcare Provider Details

I. General information

NPI: 1528287919
Provider Name (Legal Business Name): CALIFORNIA CHILDREN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 MARKET ST SUITE 300
SAN FRANCISCO CA
94105-2854
US

IV. Provider business mailing address

3976 OAK HILL RD
OAKLAND CA
94605-4931
US

V. Phone/Fax

Practice location:
  • Phone: 415-904-9682
  • Fax: 415-904-9698
Mailing address:
  • Phone: 510-635-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number260789
License Number StateCA

VIII. Authorized Official

Name: ANNETTE IRVING
Title or Position: PROGRAM MANAGER
Credential:
Phone: 415-904-9688