Provider Demographics
NPI:1588727986
Name:CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT
Entity type:Organization
Organization Name:CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RDA, RDH, MPA/HSA
Authorized Official - Phone:510-723-6951
Mailing Address - Street 1:7600 DUBLIN BLVD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7040
Mailing Address - Country:US
Mailing Address - Phone:925-485-5208
Mailing Address - Fax:510-723-7089
Practice Address - Street 1:25555 HESPERIAN BLVD
Practice Address - Street 2:BUILDING #2200
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545
Practice Address - Country:US
Practice Address - Phone:510-723-6900
Practice Address - Fax:510-723-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QD0000X
CA261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9338401Medicaid