Basic Information
Provider Information
NPI: 1245806975
EntityType: 2
ReplacementNPI:  
OrganizationName: BAY AREA COMMUNITY SERVICES, INC.
LastName:  
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Mailing Information
Address1: 390 40TH ST
Address2:  
City: OAKLAND
State: CA
PostalCode: 946092633
CountryCode: US
TelephoneNumber: 5106130330
FaxNumber:  
Practice Location
Address1: 314 BADEN AVE
Address2:  
City: SOUTH SAN FRANCISCO
State: CA
PostalCode: 940804715
CountryCode: US
TelephoneNumber: 5106130330
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/02/2021
LastUpdateDate: 06/02/2021
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: KATZ-LEWIS
AuthorizedOfficialFirstName: HANAN
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AuthorizedOfficialTitleorPosition: QIA
AuthorizedOfficialTelephone: 4153171071
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 06/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251J00000X  Y AgenciesNursing Care 

No ID Information.


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