| Rosa Parks | |
|
521 W Grand Ave Oakland CA 94612-1649 | |
| (510) 663-7313 | |
| (510) 663-2409 |
| Full Name | Rosa Parks |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 521 W Grand Ave, Oakland, California |
| Authorized Official Name and Position | Robert Eugene Barrer (ASSISTANT DIRECTOR) |
| Authorized Official Contact | 5106498174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosa Parks 2065 Kittredge St Suite E Berkeley CA 94704-1404 Ph: (510) 649-1930 | Rosa Parks 521 W Grand Ave Oakland CA 94612-1649 Ph: (510) 663-7313 |
| NPI Number | 1346544996 |
|---|---|
| Provider Enumeration Date | 12/22/2010 |
| Last Update Date | 01/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346544996 | NPI | - | NPPES |
| 8136 | Medicaid | CA | |
| 8133 | Medicaid | CA | |
| 8134 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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