Provider Demographics
NPI:1497093355
Name:CENTER FOR SOCIAL DYNAMICS
Entity Type:Organization
Organization Name:CENTER FOR SOCIAL DYNAMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-309-7981
Mailing Address - Street 1:400 29TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3522
Mailing Address - Country:US
Mailing Address - Phone:510-268-8120
Mailing Address - Fax:
Practice Address - Street 1:400 29TH ST STE 105
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3546
Practice Address - Country:US
Practice Address - Phone:510-268-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-27
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health