Provider Demographics
NPI:1124454764
Name:EBAC-CLAREMONT MIDDLE SCHOOL
Entity type:Organization
Organization Name:EBAC-CLAREMONT MIDDLE SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF QA & QI
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:510-918-8424
Mailing Address - Street 1:303 VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4340
Mailing Address - Country:US
Mailing Address - Phone:510-918-8424
Mailing Address - Fax:
Practice Address - Street 1:5750 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1629
Practice Address - Country:US
Practice Address - Phone:510-918-8424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST BAY AGENCY FOR CHILDREN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-14
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health