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General NPI Number Information
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NPI Number | 1346530227
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 8711 MACARTHUR BLVD
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City | OAKLAND
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State | CA
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Zip | 94605-4000
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Country | US
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Telephone | 510-428-3885
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Fax | 510-428-3840
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Provider Business Mailing Address
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Address Line | PO BOX 742403
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City | LOS ANGELES
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State | CA
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Zip | 90074-2403
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Country | US
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Telephone | 510-428-3885
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Fax | 510-428-3840
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Authorized Official
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Title or Position | DIRECTOR BEHAVIORAL HEALTH
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Name | SETH GOLDBERG
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Credential | PSYD
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Telephone | 510-428-3885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | 140000015
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License Number State | CA
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