NPIMap

Organization Active NPI

Children's Hospital & Research Center at Oakland

  • Student Health Clinic/Center
  • Oakland, CA
National Provider Identifier
1346530227
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
140000015 Issued in CA
Legal business name
CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
Practice address
8711 Macarthur Blvd
Oakland, CA 94605-4000
Phone
(510) 428-3885
Fax
(510) 428-3840
NPI assigned
Apr 13, 2011
Last updated
Sep 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Seth Goldberg, PSYD
Title
Director Behavioral Health
Phone
(510) 428-3885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X 140000015 CA Primary

Addresses

Primary practice location

8711 Macarthur Blvd
Oakland, CA 94605-4000

Mailing address

PO Box 742403
Los Angeles, CA 90074-2403
Phone (510) 428-3885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121221000291 CA Part A Provider - Hospital 3678725660 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oakland, CA; Walnut Creek, CA; San Ramon, CA; Brentwood, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346530227. Details of each certification follow.

Hospital certification: CCN 053301

Legal name
CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
Doing business as
UCSF BENIOFF CHILDRENS HOSPITAL OAKLAND
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Sep 1, 1983
Last certification
Jan 10, 2014
Beds
190
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 24, 1913 in CA
Enrollment address
747 52ND St
Oakland, CA 94609-1809
Other Hospital Practice Location
Hospital subgroups
Children’s

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
UCSF Benioff Children's Hospital OaklandCCN 053301 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Children's Hospital and Research Center-Oakland22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Ownership & related parties

All disclosed owners & managing parties 31

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elisa Stad Individual Corporate Director Mar 31, 2016
Thomas Bret Individual Corporate Director Jan 1, 2016
Robert Scott Fries Individual Corporate OfficerCfo Dec 15, 2015
W-2 Managing EmployeeChief Financial Officer Dec 15, 2015
Timothy Kendall Individual Corporate Director Jan 1, 2016
Carolyn B Klebanoff Individual Corporate Director Dec 7, 2016
Lynne Benioff Individual Corporate DirectorBoard Member Jan 1, 2014
Michael R Anderson Individual Corporate OfficerPresident Dec 12, 2016
Robin Washington Individual Corporate Director May 28, 2015
David J Durand Individual W-2 Managing EmployeeChief Medical Officer Feb 13, 2013
Carrie Wheeler Individual Corporate Officer Aug 25, 2014
Corporate Director Aug 25, 2014
Edward Penhoet Individual Corporate OfficerSecretary Jan 1, 2015
Corporate DirectorSecretary/Board Member Feb 24, 2011
Melissa Williams Individual Corporate Director Mar 31, 2016
Ronald Alan Cohen Individual Corporate Director Apr 1, 2018
University of California San Francisco Organization, San Francisco, CA Other Jan 1, 2014
Mark Laret Individual Corporate DirectorBoard Member Jan 1, 2014
Charles Cole Individual Corporate Director Mar 31, 2016
Nancy Shibata Individual W-2 Managing EmployeeSVP Clinical Ops, Chief Nursing Off May 1, 2012
George Weiss Individual W-2 Managing EmployeeVP Ambulatory Services Dec 28, 2017
Valli Benesch Individual Corporate Director Sep 29, 2016
Jeffrey Cheung Individual Corporate OfficerTreasurer Jan 1, 2015
Jamie Phillips Individual W-2 Managing EmployeeChief Operating Officer Apr 23, 2018
Jason Moment Individual Corporate Director Jan 1, 2016
David Beier Individual Corporate Director May 28, 2015
Louis Lavigne Individual Corporate Director Sep 29, 2011
Samir Kaul Individual Corporate Director Dec 6, 2017
Robert Pedrero Individual Corporate Director Sep 24, 2017
Phyllis Weiss Individual W-2 Managing EmployeeVP, Human Resources Jan 8, 2016
John Protopappas Individual Corporate Director Sep 24, 2017
Farah Champsi Individual Corporate Director Jan 1, 2016
Shahan Soghikian Individual Corporate OfficerChair Jan 1, 2017
Corporate Director Mar 29, 2012
Talmadge E King Individual Corporate Director May 26, 2015

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 14

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1346530227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742403",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742403",
            "telephone_number": "510-428-3885",
            "fax_number": "510-428-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8711 MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054000",
            "telephone_number": "510-428-3885",
            "fax_number": "510-428-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-13",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "DIRECTOR BEHAVIORAL HEALTH",
        "authorized_official_telephone_number": "510-428-3885",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "CA",
            "license": "140000015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.