Provider Demographics
NPI:1609036920
Name:BOYD, AREDA FAYE
Entity Type:Individual
Prefix:
First Name:AREDA
Middle Name:FAYE
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 BANCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-5103
Mailing Address - Country:US
Mailing Address - Phone:510-769-0271
Mailing Address - Fax:510-357-0688
Practice Address - Street 1:1395 BANCROFT AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-5103
Practice Address - Country:US
Practice Address - Phone:510-769-0271
Practice Address - Fax:510-357-0688
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator