Provider Demographics
NPI:1386195337
Name:CITY OF FREMONT YOUTH AND FAMILY SERVICES
Entity Type:Organization
Organization Name:CITY OF FREMONT YOUTH AND FAMILY SERVICES
Other - Org Name:NILES ELEMENTARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:510-574-2114
Mailing Address - Street 1:39155 LIBERTY ST
Mailing Address - Street 2:SUITE E500
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94537-5006
Mailing Address - Country:US
Mailing Address - Phone:510-574-2100
Mailing Address - Fax:510-574-2105
Practice Address - Street 1:37141 2ND ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-2835
Practice Address - Country:US
Practice Address - Phone:510-793-1141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF FREMONT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-14
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health