MEDICARE: THE WEST OAKLAND HEALTH COUNCIL

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
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457471500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WEST OAKLAND HEALTH COUNCIL

Provider Business Mailing Address
First Line	:	700 ADELINE ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94607-2608
Country	:	US
Telephone Number	:	510-835-9610
Fax Number	:	510-272-0209

Provider Business Practice Location Address
First Line	:	1890 ALCATRAZ AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-2715
Country	:	US
Telephone Number	:	510-601-0167
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ERIKA SIMPSON-AKPAWU
Credential	:
Telephone Number	:	510-835-9610

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	03/01/2022

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