Provider Demographics
NPI:1295558260
Name:CAPUT POONS G
Entity type:Organization
Organization Name:CAPUT POONS G
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJANDRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:510-516-3188
Mailing Address - Street 1:5422 SHAFTER AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1189
Mailing Address - Country:US
Mailing Address - Phone:510-516-3188
Mailing Address - Fax:
Practice Address - Street 1:5661 KEITH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1542
Practice Address - Country:US
Practice Address - Phone:415-287-2288
Practice Address - Fax:415-688-2748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty