Provider Demographics
NPI:1124880299
Name:OGDEN, JAMES JOSEPH
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:OGDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 VERSAILLES AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1655
Mailing Address - Country:US
Mailing Address - Phone:151-020-5269
Mailing Address - Fax:
Practice Address - Street 1:202 E BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2305
Practice Address - Country:US
Practice Address - Phone:510-295-2698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16478101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)