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General NPI Number Information
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NPI Number | 1447398896
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOSPITAL AND RESEARCH CENTER AT OAKLAND
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 747 52ND ST
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3649
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Fax | 510-601-3973
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Provider Business Mailing Address
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Address Line | 747 52ND ST
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3649
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Fax | 510-601-3973
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHERISE NORTHCUTT
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Credential | PH.D.
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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 | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | PSY 19128
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License Number State | CA
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