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Frances Taylor Slack Raeside

Marriage & Family Therapist

Behavioral Health & Social Service Providers

5263 Claremont Ave, Oakland, CA 94618-1032

PECOS Enrollment

Based on the most recent information from CMS, provider Frances Taylor Slack Raeside does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1578742409
Provider Type
Individual
Full Name
Raeside, Frances Taylor Slack
Title
Mrs.
Credential
MFT

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/27/2007
Last Updated
10/27/2007

Contact Information

Practice Location

5263 Claremont Ave, Oakland, CA 94618-1032

(510) 596-8125

Unlisted Fax

Mailing Location

662 Kenwyn Rd, Oakland, CA 94610-3737

(510) 839-3424

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License MFC35637 California
Code 101Y00000X	Description Counselor Behavioral Health & Social Service Providers	License MFC35637 California
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License MFC35637
Code 101YP2500X	Description Counselor Behavioral Health & Social Service Providers	License MFC35637 California

Frances Taylor Slack Raeside

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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