NPIMap

Organization Active NPI

East Bay Agency for Children

Doing business as EBAC-Roots Intl Academy & Coliseum College Prep Academy

  • Community/Behavioral Health Agency
  • Oakland, CA
National Provider Identifier
1467889162
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EAST BAY AGENCY FOR CHILDREN
Doing business as
EBAC-Roots Intl Academy & Coliseum College Prep Academy
Practice address
1390 66TH Ave
Oakland, CA 94621-3506
Phone
(510) 918-8424
NPI assigned
Sep 26, 2013
Last updated
Jul 29, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST BAY AGENCY FOR CHILDRENAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Jeannette Rodriguez
Title
Cqi Administrative Coordinator
Phone
(510) 844-5368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1390 66TH Ave
Oakland, CA 94621-3506

Mailing address

2828 Ford St
Oakland, CA 94601-2114
Phone (510) 268-3770

Other names 1

  • EBAC-Roots Intl Academy & Coliseum College Prep Academy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Bay Activity Ctr61 organizations share this tax ID, including this one
Part of
East Bay Activity Ctr

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1467889162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 FORD ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012114",
            "telephone_number": "510-268-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 66TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946213506",
            "telephone_number": "510-918-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY AGENCY FOR CHILDREN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST BAY AGENCY FOR CHILDREN",
        "enumeration_date": "2013-09-26",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_title_or_position": "CQI ADMINISTRATIVE COORDINATOR",
        "authorized_official_telephone_number": "510-844-5368"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EBAC-Roots Intl Academy & Coliseum College Prep Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.