Provider Demographics
NPI:1255691036
Name:CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
Entity Type:Organization
Organization Name:CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:510-428-3467
Mailing Address - Street 1:747 52ND STREET
Mailing Address - Street 2:SEED PROGRAM
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1809
Mailing Address - Country:US
Mailing Address - Phone:510-428-3000
Mailing Address - Fax:
Practice Address - Street 1:5275 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609
Practice Address - Country:US
Practice Address - Phone:510-428-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S HOSPITAL & RESEARCH CENTER AT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-25
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health