Healthcare Provider Details
I. General information
NPI: 1396178794
Provider Name (Legal Business Name): ALAMEDA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2013
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16335 E 14TH STREET ROOM 109 & 117
SAN LEANDRO CA
94578-3109
US
IV. Provider business mailing address
PO BOX 129
SAN LEANDRO CA
94577-0929
US
V. Phone/Fax
- Phone: 510-667-3276
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KARYN
L
TRIBBLE
Title or Position: DIRECTOR
Credential: PSYD, LCSW
Phone: 510-567-8100