Fred Finch Youth Center
Organization Active NPI Community/Behavioral Health Agency · Oakland, CA
NPI 1316009558 · NPPES record last updated Jul 28, 2022
Key facts
- NPI
- 1316009558
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- FRED FINCH YOUTH CENTER
- Practice address
- 3800 Coolidge Ave
Oakland, CA 94602-3311 - Phone
- (510) 482-2244
- Fax
- (510) 488-1960
- NPI assigned
- Dec 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Thomas N Alexander, LCSW
- Title
- President and Ceo
- Phone
- (510) 482-2244
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 24
Practitioners 5
-
Megan Christine O'Brien, PMHNP
-
Funmilola Umoren, NP
-
Roger Wayne Daniels, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130226000326 | CA | Part B Supplier - Clinic/Group Practice | 4486809381 |
Receives reassigned benefits from 2 practitioners 3 other NPIs on this enrollment Practice locations: Oakland, CA |
National Provider Directory
- Tax ID family
- Fred Finch Children'S Home
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Mental Health Counselor |
101YM0800X | |||
| School Counselor |
101YS0200X | |||
| Psychologist |
103T00000X | |||
| Cognitive & Behavioral Psychologist |
103TB0200X | |||
| Clinical Psychologist |
103TC0700X | |||
| Clinical Child & Adolescent Psychologist |
103TC2200X | |||
| Intellectual & Developmental Disabilities Psychologist |
103TM1800X | |||
| Clinical Social Worker |
1041C0700X | |||
| Marriage & Family Therapist |
106H00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Yes | ||
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X |
Addresses
Primary practice location
3800 Coolidge Ave
Oakland, CA 94602-3311
Mailing address
3800 Coolidge Ave
Oakland, CA 94602-3311
Phone (510) 482-2244
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01260208 | Medicaid | CA | |
| 01870808 | Medicaid | CA | |
| 00G503291 | Other | CA | PROVIDER ID |
| 00113 | Other | CA | LEGAL ENTITY NUMBER |
| 01761908 | Medicaid | CA |
Other providers in Oakland, CA
- Fred Finch
- Fred Finch Youth & Family Services
- Fred Finch Youth Center
- Fred Finch Youth Center
- Fred Finch Youth Center
- Fred Finch Youth Center
- Fred Finch Youth Center
- Fred Finch Youth Center
- Fred Finch Youth Center
- Fred Finch Youth Center
All providers in Oakland, CA · Community/Behavioral Health Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.