Provider Demographics
NPI:1164506069
Name:HERS BREAST CANCER FOUNDATION
Entity Type:Organization
Organization Name:HERS BREAST CANCER FOUNDATION
Other - Org Name:BRAS FOR BODY & SOUL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ STECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-790-1911
Mailing Address - Street 1:2500 MOWRY AVE
Mailing Address - Street 2:SUITE #130
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1605
Mailing Address - Country:US
Mailing Address - Phone:510-790-1911
Mailing Address - Fax:510-505-9160
Practice Address - Street 1:2500 MOWRY AVE
Practice Address - Street 2:SUITE #130
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1605
Practice Address - Country:US
Practice Address - Phone:510-790-1911
Practice Address - Fax:510-505-9160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4819040001Medicare ID - Type Unspecified