| Eden Outpatient | |
|
2045 Fairmont Dr San Leandro CA 94578-1088 | |
| (800) 878-1313 | |
| Not Available |
| Full Name | Eden Outpatient |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2045 Fairmont Dr, San Leandro, California |
| Authorized Official Name and Position | Karyn L Tribble (DIRECTOR) |
| Authorized Official Contact | 5105678100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eden Outpatient Po Box 129 San Leandro CA 94577-0929 Ph: () - | Eden Outpatient 2045 Fairmont Dr San Leandro CA 94578-1088 Ph: (800) 878-1313 |
| NPI Number | 1023140787 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023140787 | NPI | - | NPPES |
| 000000112 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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