Provider Demographics
NPI:1518154863
Name:JAMES, AUBREY I
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:I
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:AUBREY
Other - Middle Name:I
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:467 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3614
Mailing Address - Country:US
Mailing Address - Phone:510-663-7313
Mailing Address - Fax:
Practice Address - Street 1:1820 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1543
Practice Address - Country:US
Practice Address - Phone:510-663-7313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8133Medicaid
CA81331Medicaid