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NPI Code Detail

MEDICARE: EAST BAY AGENCY FOR CHILDREN

MEDICARE: EAST BAY AGENCY FOR CHILDREN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1194924092
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST BAY AGENCY FOR CHILDREN
Provider Business Mailing Address
First Line : 2828 FORD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2114
Country : US
Telephone Number : 510-268-3770
Fax Number : 510-268-1073
Provider Business Practice Location Address
First Line : 2828 FORD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2114
Country : US
Telephone Number : 510-268-3770
Fax Number : 510-268-1073
Authorized Official
Title or Position : CQI ADMINISTRATIVE COORDINATOR
Name : JEANNETTE RODRIGUEZ
Credential :
Telephone Number : 510-844-5368
Provider Enumeration Date : 07/12/2007
Last Update Date : 02/02/2023

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Directions to “EAST BAY AGENCY FOR CHILDREN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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