Basic Information
| Provider Information | |||||||||
| NPI: | 1194170381 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GIRLS INCORPORATED OF ALAMEDA COUNTY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 510 16TH ST | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946121520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103575515 | ||||||||
| FaxNumber: | 5103185396 | ||||||||
| Practice Location | |||||||||
| Address1: | 2251 BANCROFT AVE | ||||||||
| Address2: | |||||||||
| City: | SAN LEANDRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103575515 | ||||||||
| FaxNumber: | 5103185396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2016 | ||||||||
| LastUpdateDate: | 04/26/2016 | ||||||||
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| AuthorizedOfficialLastName: | VIRGIL | ||||||||
| AuthorizedOfficialFirstName: | JULAYNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5103575515 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.