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General NPI Number Information
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NPI Number | 1649552936
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Entity Type | Individual
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Provider Name | MR. HAROLD L JEFFERSON
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Gender | Male
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 2540 CHARLESTON ST OAKLAND DAY TREATMENT
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City | OAKLAND
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State | CA
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Zip | 94602-2508
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Country | US
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Telephone | 510-531-3666
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Fax | 510-531-0691
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Provider Business Mailing Address
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Address Line | 2828 FORD ST
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City | OAKLAND
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State | CA
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Zip | 94601-2114
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Country | US
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Telephone | 510-407-6667
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Fax | 510-531-0691
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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