Provider Demographics
NPI:1851842249
Name:CITY OF FREMONT
Entity Type:Organization
Organization Name:CITY OF FREMONT
Other - Org Name:CENTERVILLE JUNIOR HIGH SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:510-574-2114
Mailing Address - Street 1:39155 LIBERTY ST
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 1:37720 FREMONT BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5025
Practice Address - Country:US
Practice Address - Phone:510-574-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health