Healthcare Provider Details

I. General information

NPI: 1861693657
Provider Name (Legal Business Name): ALAMEDA HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15400 FOOTHILL BLVD BLDG E
SAN LEANDRO CA
94578-1009
US

IV. Provider business mailing address

15400 FOOTHILL BLVD
SAN LEANDRO CA
94578-1009
US

V. Phone/Fax

Practice location:
  • Phone: 510-895-7230
  • Fax: 510-895-4231
Mailing address:
  • Phone: 510-895-7344
  • Fax: 510-895-7229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number140000046
License Number StateCA

VIII. Authorized Official

Name: BERNADETTE JENSEN
Title or Position: VP OF REVENUE CYCLE
Credential:
Phone: 510-618-2147