Basic Information
| Provider Information | |||||||||
| NPI: | 1760697221 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NATIVE AMERICAN HEALTH SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3124 INTERNATIONAL BLVD # 2 | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946012902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105354400 | ||||||||
| FaxNumber: | 5102616438 | ||||||||
| Practice Location | |||||||||
| Address1: | 3124 INTERNATIONAL BLVD # 2 | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946012902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105354400 | ||||||||
| FaxNumber: | 5102616438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | JAMERSON | ||||||||
| AuthorizedOfficialFirstName: | SUSAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5105354472 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MPH | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | FHC11743F | CA | Y | Agencies | Community/Behavioral Health |
No ID Information.