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General NPI Number Information
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NPI Number | 1366871188
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Entity Type | Organization
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Legal Business Name | OAKLAND UNIFIED SCHOOL DISTRICT
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 991 14TH ST
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City | OAKLAND
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State | CA
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Zip | 94607-3230
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Country | US
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Telephone | 510-874-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 UNION ST
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City | OAKLAND
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State | CA
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Zip | 94607-2236
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Country | US
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Telephone | 510-879-8391
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Fax |
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR
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Name | GENEVIEVE HIGGINS REIS
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Credential | LCSW
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Telephone | 510-879-8391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 21739
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License Number State | CA
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