Provider Demographics
NPI:1114364676
Name:EAST BAY AGENCY FOR CHILDREN
Entity Type:Organization
Organization Name:EAST BAY AGENCY FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIENT SERVICES SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-844-5369
Mailing Address - Street 1:303 VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4340
Mailing Address - Country:US
Mailing Address - Phone:510-268-3770
Mailing Address - Fax:
Practice Address - Street 1:1111 2ND AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-2285
Practice Address - Country:US
Practice Address - Phone:510-268-3770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST BAY AGENCY FOR CHILDREN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-23
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health