Provider Demographics
NPI:1790185536
Name:CITY OF FREMONT
Entity Type:Organization
Organization Name:CITY OF FREMONT
Other - Org Name:CHADBOURNE ELEMENTARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MPA, LMFT
Authorized Official - Phone:510-574-2100
Mailing Address - Street 1:39155 LIBERTY STREET
Mailing Address - Street 2:SUITE E500
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94537-5006
Mailing Address - Country:US
Mailing Address - Phone:510-574-2100
Mailing Address - Fax:
Practice Address - Street 1:801 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-4637
Practice Address - Country:US
Practice Address - Phone:510-656-5242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health