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NPI Code Detail

MEDICARE: TELECARE CORPORATION

MEDICARE: TELECARE CORPORATION
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18160OTHERCACOUNTY MENTAL HEALTH CERTIFICATE

General Provider Information

NPI Number : 1598852741
Entity Type Code : Organization
Provider Name (Legal Business Name) : TELECARE CORPORATION
Provider Business Mailing Address
First Line : 1080 MARINA VILLAGE PKWY
Second Line : SUITE 100
City : ALAMEDA
State : CA
Zip : 94501-6427
Country : US
Telephone Number : 510-337-7950
Fax Number : 510-337-7969
Provider Business Practice Location Address
First Line : 280 17TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94612-4124
Country : US
Telephone Number : 510-352-9890
Fax Number : 510-352-9981
Authorized Official
Title or Position : CFO, VICE PRESIDENT
Name : MARSHALL LANGFIELD
Credential :
Telephone Number : 510-337-7950
Provider Enumeration Date : 10/09/2006
Last Update Date : 03/08/2010

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1700932100 — MRS. MARILYN JANE CALLAHAN
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Directions to “TELECARE CORPORATION ” Practice Location

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