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General NPI Number Information
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NPI Number | 1144820499
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES OF THE DIOCESE OF OAKLAND
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 3700 DORISA AVE
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City | OAKLAND
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State | CA
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Zip | 94605-4941
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Country | US
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Telephone | 510-768-3100
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Fax | 510-890-4917
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Provider Business Mailing Address
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Address Line | 433 JEFFERSON ST
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City | OAKLAND
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State | CA
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Zip | 94607-3539
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Country | US
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Telephone | 510-768-3100
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Fax | 510-451-6998
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Authorized Official
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Title or Position | CHIEF PROGRAM OFFICER
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Name | CHRISTOPHER NERY MARTINEZ
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Credential |
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Telephone | 510-823-7517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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