Provider Demographics
NPI:1427488980
Name:CITY OF FREMONT, HUMAN SERVICES DEPARTMENT, MSSP
Entity type:Organization
Organization Name:CITY OF FREMONT, HUMAN SERVICES DEPARTMENT, MSSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY HUMAN SERVICES DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARQUIMIDES
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-574-2056
Mailing Address - Street 1:3300 CAPITOL AVE
Mailing Address - Street 2:BUILDING B
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1514
Mailing Address - Country:US
Mailing Address - Phone:510-574-2050
Mailing Address - Fax:510-574-2054
Practice Address - Street 1:3300 CAPITOL AVE
Practice Address - Street 2:BUILDING B
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1514
Practice Address - Country:US
Practice Address - Phone:510-574-2050
Practice Address - Fax:510-574-2054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty