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General NPI Number Information
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NPI Number | 1669381588
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Entity Type | Individual
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Provider Name | KHIRY DEVON FOSTER
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Gender | Male
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 22245 MAIN ST STE 200
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City | HAYWARD
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State | CA
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Zip | 94541-4028
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Country | US
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Telephone | 510-727-9401
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Fax | 510-727-9405
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Provider Business Mailing Address
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Address Line | 300 SUNNYHILLS DR
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City | SAN ANSELMO
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State | CA
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Zip | 94960-1909
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Country | US
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Telephone | 510-727-9401
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Fax | 510-727-9405
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 22433
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number | 22433
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 22433
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License Number State | CA
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