Provider Demographics
NPI:1881416220
Name:LOEB, ELANA YOSEFA
Entity type:Individual
Prefix:
First Name:ELANA
Middle Name:YOSEFA
Last Name:LOEB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 INTERNATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-2376
Mailing Address - Country:US
Mailing Address - Phone:650-248-4889
Mailing Address - Fax:
Practice Address - Street 1:1909 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1023
Practice Address - Country:US
Practice Address - Phone:510-809-3004
Practice Address - Fax:510-809-3240
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator