| Longfellow Middle School | |
|
1500 Derby St Berkeley CA 94703-1817 | |
| (510) 644-6360 | |
| Not Available |
| Full Name | Longfellow Middle School |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1500 Derby St, Berkeley, California |
| Authorized Official Name and Position | Sandy Hobson (QUALITY ASSURANCE DIRECTOR) |
| Authorized Official Contact | 5107255727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Longfellow Middle School 2275 Arlington Dr San Leandro CA 94578-1132 Ph: (510) 654-4004 | Longfellow Middle School 1500 Derby St Berkeley CA 94703-1817 Ph: (510) 644-6360 |
| NPI Number | 1669752937 |
|---|---|
| Provider Enumeration Date | 08/18/2011 |
| Last Update Date | 09/02/2020 |
| Certification Date | 09/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669752937 | NPI | - | NPPES |
| 0015 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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