Provider Demographics
NPI:1912299249
Name:OP PLUS 1
Entity type:Organization
Organization Name:OP PLUS 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AST. EXEC. DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:NERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-848-5446
Mailing Address - Street 1:33 OAK HILL CIR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-4547
Mailing Address - Country:US
Mailing Address - Phone:510-638-1277
Mailing Address - Fax:510-635-7852
Practice Address - Street 1:6915 NORFOLK RD
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1738
Practice Address - Country:US
Practice Address - Phone:510-848-5446
Practice Address - Fax:510-848-1373
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPPORTUNITY PLUS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01144143261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA011441143OtherCOMMUNITY CARE LICENSING