| City Of Fremont | |
|
3300 Capitol Ave Bldg B Fremont CA 94538-1514 | |
| (510) 574-2050 | |
| (510) 574-2054 |
| Full Name | City Of Fremont |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3300 Capitol Ave, Fremont, California |
| Authorized Official Name and Position | Arquimides Caldera (DEPUTY DIRECTOR) |
| Authorized Official Contact | 5105742056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| City Of Fremont 3300 Capitol Ave Bldg B Fremont CA 94538-1514 Ph: (510) 574-2050 | City Of Fremont 3300 Capitol Ave Bldg B Fremont CA 94538-1514 Ph: (510) 574-2050 |
| NPI Number | 1306934252 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 04/09/2014 |
| Medicare PECOS PAC ID | 5991880007 |
|---|---|
| Medicare Enrollment ID | O20080313000643 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306934252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Sudha Manjunath |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801826797 PECOS PAC ID: 1153321278 Enrollment ID: I20070112000391 |
| Provider Name | Ihande M Weber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578778643 PECOS PAC ID: 1759466766 Enrollment ID: I20080313000703 |
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