| Irvington High School | |
|
41800 Blacow Rd Fremont CA 94538-3353 | |
| (510) 656-5711 | |
| Not Available |
| Full Name | Irvington High School |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 41800 Blacow Rd, Fremont, California |
| Authorized Official Name and Position | Annie Bailey (ADMINISTRATOR) |
| Authorized Official Contact | 5105742100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Irvington High School 39155 Liberty Street Suite E500 Fremont CA 94537-5006 Ph: (510) 574-2100 | Irvington High School 41800 Blacow Rd Fremont CA 94538-3353 Ph: (510) 656-5711 |
| NPI Number | 1205237575 |
|---|---|
| Provider Enumeration Date | 09/05/2014 |
| Last Update Date | 08/24/2020 |
| Certification Date | 08/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205237575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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