| Bay Area Community Services Inc | |
|
629 Oakland Ave Oakland CA 94611-4567 | |
| (510) 613-0330 | |
| Not Available |
| Full Name | Bay Area Community Services Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 629 Oakland Ave, Oakland, California |
| Authorized Official Name and Position | Michael Stanton Ward (GENERAL COUNSEL) |
| Authorized Official Contact | 5102197451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Area Community Services Inc 390 40th St Oakland CA 94609-2633 Ph: (510) 613-0330 | Bay Area Community Services Inc 629 Oakland Ave Oakland CA 94611-4567 Ph: (510) 613-0330 |
| NPI Number | 1235349572 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 01/11/2021 |
| Certification Date | 01/11/2021 |
| Medicare PECOS PAC ID | 5890028781 |
|---|---|
| Medicare Enrollment ID | O20190607001798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235349572 | NPI | - | NPPES |
| 01028 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Edward Lim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386660447 PECOS PAC ID: 1850297664 Enrollment ID: I20031211000649 |
| Provider Name | Christopher E Berger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063679017 PECOS PAC ID: 9335394667 Enrollment ID: I20130312000386 |
| Provider Name | Lauren Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538506126 PECOS PAC ID: 4183942410 Enrollment ID: I20150427002395 |
| Provider Name | Andrea Masters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457861783 PECOS PAC ID: 8820335227 Enrollment ID: I20190123002095 |
| Provider Name | Jasmine Malika Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275997637 PECOS PAC ID: 5597002725 Enrollment ID: I20190125003099 |
| Provider Name | Joseph N Kenan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225302755 PECOS PAC ID: 0345499281 Enrollment ID: I20190927000407 |
| Provider Name | Kevin S Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225370885 PECOS PAC ID: 6103258751 Enrollment ID: I20191119003333 |
| Provider Name | Lawrence W Bryer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922395797 PECOS PAC ID: 8921431479 Enrollment ID: I20191213001884 |
| Provider Name | Marilyn Jean Vache |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851314157 PECOS PAC ID: 6608893557 Enrollment ID: I20191213002281 |
| Provider Name | Katherine L. Lutz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780062471 PECOS PAC ID: 0648604686 Enrollment ID: I20191227000254 |
| Provider Name | Paul Julio Calloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457764086 PECOS PAC ID: 7012342736 Enrollment ID: I20200127000894 |
| Provider Name | Robert R Delisle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598194268 PECOS PAC ID: 6507281425 Enrollment ID: I20200810000160 |
| Provider Name | Maitreya Deva Rosiles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235565516 PECOS PAC ID: 4082004148 Enrollment ID: I20211203000073 |
| Provider Name | Sarah Kahleen Hines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841430022 PECOS PAC ID: 4183095722 Enrollment ID: I20230119000435 |
| Provider Name | Brittney Lee Diebold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699201004 PECOS PAC ID: 0446622682 Enrollment ID: I20230215002929 |
| Provider Name | Jeanette Lenay Nunes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700549177 PECOS PAC ID: 4688042997 Enrollment ID: I20230328001119 |
| Provider Name | Shwetha Katta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184039042 PECOS PAC ID: 6103043138 Enrollment ID: I20230612000998 |
| Provider Name | Jonathan Darrell Rowland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255099107 PECOS PAC ID: 8921466467 Enrollment ID: I20230615001652 |
| Provider Name | Britany Oliver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104376839 PECOS PAC ID: 3971964065 Enrollment ID: I20230807000015 |
| Provider Name | Ana-naomi Racataian Holland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790215408 PECOS PAC ID: 8325409329 Enrollment ID: I20230807000837 |
| Provider Name | Brian Kenneth Lempa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891228144 PECOS PAC ID: 3072886589 Enrollment ID: I20230919003697 |
| Provider Name | Carla M Felten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194152355 PECOS PAC ID: 1658716402 Enrollment ID: I20240301003647 |
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