Provider Demographics
NPI:1861863201
Name:EAST BAY AGENCY FOR CHILDREN
Entity Type:Organization
Organization Name:EAST BAY AGENCY FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTINUOUS QUALITY ASSURANCE MGR.
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-844-6720
Mailing Address - Street 1:303 VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4340
Mailing Address - Country:US
Mailing Address - Phone:510-844-5369
Mailing Address - Fax:
Practice Address - Street 1:37490 BIRCH ST
Practice Address - Street 2:LOUIS MILANI ELEMENTARY SCHOOL
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-4140
Practice Address - Country:US
Practice Address - Phone:510-818-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST BAY AGENCY FOR CHILDREN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health