1932265204 NPI number — ALAMEDA HEALTH SYSTEM

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932265204 NPI number — ALAMEDA HEALTH SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALAMEDA HEALTH SYSTEM
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:
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:
1932265204
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15400 FOOTHILL BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN LEANDRO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94578-1009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-895-7344
Provider Business Mailing Address Fax Number:
510-895-7229

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15400 FOOTHILL BLVD BLDG E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN LEANDRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94578-1009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-895-4200
Provider Business Practice Location Address Fax Number:
510-895-4231
Provider Enumeration Date:
12/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JENSEN
Authorized Official First Name:
BERNADETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF REVENUE CYCLE
Authorized Official Telephone Number:
510-618-2147

Provider Taxonomy Codes

  • Taxonomy code: 3336I0012X , with the licence number:  HPE40904 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PHB356020 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0562024 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




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