Provider Demographics
NPI:1609387562
Name:CITY OF FREMONT
Entity Type:Organization
Organization Name:CITY OF FREMONT
Other - Org Name:BRIDGEPOINT HIGH SCHOOL - MACGREGOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY DIRECTOR, HUMAN SERVICES DEP
Authorized Official - Prefix:
Authorized Official - First Name:ARQUIMIDES
Authorized Official - Middle Name:TOMAS
Authorized Official - Last Name:CALDERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-574-2056
Mailing Address - Street 1:3300 CAPITOL AVE BLDG B
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35753 CEDAR BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-1324
Practice Address - Country:US
Practice Address - Phone:510-574-2137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health