Provider Demographics
NPI:1356673503
Name:ALAMEDA HEALTH SYSTEM
Entity Type:Organization
Organization Name:ALAMEDA HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-618-2147
Mailing Address - Street 1:15400 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1009
Mailing Address - Country:US
Mailing Address - Phone:510-895-7344
Mailing Address - Fax:510-895-7229
Practice Address - Street 1:13855 E 14TH ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2611
Practice Address - Country:US
Practice Address - Phone:510-437-7720
Practice Address - Fax:510-436-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140000046282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHSC00320FMedicaid
CAHSP40320FMedicaid
CAHSC00320WMedicaid
CA050320Medicare Oscar/Certification