Provider Demographics
NPI:1568669182
Name:OAKLAND UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:OAKLAND UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:YASEMSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-297-4068
Mailing Address - Street 1:2850 WEST ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-4536
Mailing Address - Country:US
Mailing Address - Phone:510-879-8481
Mailing Address - Fax:
Practice Address - Street 1:2850 WEST ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-4536
Practice Address - Country:US
Practice Address - Phone:510-879-8481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01ABMedicaid