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General NPI Number Information
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NPI Number | 1902931595
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Entity Type | Organization
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Legal Business Name | TELECARE CORPORATION
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 4704 HOEN AVE
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City | SANTA ROSA
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State | CA
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Zip | 95405-7824
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Country | US
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Telephone | 707-568-2800
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Fax | 707-568-2808
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Provider Business Mailing Address
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Address Line | 1080 MARINA VILLAGE PKWY 100
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City | ALAMEDA
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State | CA
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Zip | 94501-6427
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Country | US
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Telephone | 510-337-7950
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Fax | 510-337-7969
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Authorized Official
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Title or Position | PROVIDER RELATIONS SUPERVISOR
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Name | LORENA LOPEZ
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Credential |
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Telephone | 510-337-7950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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