Provider Demographics
NPI:1144429754
Name:CHILDREN'S HOSPITAL AND RESEARCH CENTER-OAKLAND
Entity Type:Organization
Organization Name:CHILDREN'S HOSPITAL AND RESEARCH CENTER-OAKLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH WORKER II
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:DAESHAUN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:510-428-3885
Mailing Address - Street 1:5275 CLAREMONT AVE
Mailing Address - Street 2:CENTER FOR THE VULNERABLE CHILD
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1032
Mailing Address - Country:US
Mailing Address - Phone:510-428-3885
Mailing Address - Fax:510-601-3913
Practice Address - Street 1:5275 CLAREMONT AVE
Practice Address - Street 2:CENTER FOR THE VULNERABLE CHILD
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1032
Practice Address - Country:US
Practice Address - Phone:510-428-3885
Practice Address - Fax:510-601-3913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren