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General NPI Number Information
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NPI Number | 1003093634
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Entity Type | Organization
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Legal Business Name | CORNERSTONE COMMUNITY DEVELOPMENT CORPORATION
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Dates
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Enumeration Date | 01/25/2008
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Last Update Date | 01/25/2008
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Provider Practice Location Address
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Address Line | 1395 BANCROFT AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94577-5103
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Country | US
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Telephone | 510-357-0205
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Fax | 510-357-0688
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Provider Business Mailing Address
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Address Line | 1395 BANCROFT AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94577-5103
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Country | US
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Telephone | 510-357-0205
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Fax | 510-357-0688
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ELIZABETH VARELA
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Credential |
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Telephone | 510-357-0205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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