Healthcare Provider Details
I. General information
NPI: 1861985202
Provider Name (Legal Business Name): BETH HARVEY MHRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/11/2018
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
777 DAVIS ST STE 300
SAN LEANDRO CA
94577-6923
US
IV. Provider business mailing address
2749 PLEASANT ST
OAKLAND CA
94602-2808
US
V. Phone/Fax
- Phone: 510-746-2800
- Fax:
- Phone: 510-295-8266
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225400000X |
| Taxonomy | Rehabilitation Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: