1740773902 NPI number — OAKLAND UNIFIED SCHOOL DISTRICT

Table of content: (NPI 1740773902)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740773902 NPI number — OAKLAND UNIFIED SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OAKLAND UNIFIED SCHOOL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740773902
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1011 UNION ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94607-2236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-879-8391
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1926 E 19TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94606-4126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-535-2877
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2018

Additional Information

Authorized Official

Authorized Official Last Name:
REIS
Authorized Official First Name:
GENEVIEVE
Authorized Official Middle Name:
HIGGINS
Authorized Official Title or Position:
CLINICAL SUPERVISOR
Authorized Official Telephone Number:
510-879-8391

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com