Basic Information
| Provider Information | |||||||||
| NPI: | 1922306455 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CENTER FOR EMPOWERING REFUGEES AND IMMIGRANTS | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 544 INTERNATIONAL BLVD APT 9 | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946062973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104441671 | ||||||||
| FaxNumber: | 5104444283 | ||||||||
| Practice Location | |||||||||
| Address1: | 4521 WEBSTER ST | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946092140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104441671 | ||||||||
| FaxNumber: | 5104444283 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2011 | ||||||||
| LastUpdateDate: | 03/08/2011 | ||||||||
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| AuthorizedOfficialLastName: | AFARY | ||||||||
| AuthorizedOfficialFirstName: | MONA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5104441671 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH.D., MFT | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | MFC23809 | CA | Y | Agencies | Community/Behavioral Health |
No ID Information.