Provider Demographics
NPI:1609764208
Name:TELECARE CHANGES
Entity type:Organization
Organization Name:TELECARE CHANGES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEAM SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:HEWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TESFAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-421-4739
Mailing Address - Street 1:7200 BANCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2403
Mailing Address - Country:US
Mailing Address - Phone:510-421-4739
Mailing Address - Fax:
Practice Address - Street 1:7200 BANCROFT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2403
Practice Address - Country:US
Practice Address - Phone:510-421-4739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty