Provider Demographics
NPI:1285817338
Name:JEANETTE BEER
Entity Type:Organization
Organization Name:JEANETTE BEER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHN
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:BEER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHN
Authorized Official - Phone:510-434-7673
Mailing Address - Street 1:2647 INTERNATIONAL BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-1537
Mailing Address - Country:US
Mailing Address - Phone:510-434-7673
Mailing Address - Fax:510-434-7908
Practice Address - Street 1:2647 INTERNATIONAL BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-1537
Practice Address - Country:US
Practice Address - Phone:510-434-7673
Practice Address - Fax:510-434-7908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA638882261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health