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PED053301-33 CHILDRENS HOSP & RES CNTR OAKLAND (Active)
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Main Details
Name
CHILDRENS HOSP & RES CNTR OAKLAND
Subdivision Name
UCSF Benioff Childrens Hospital Walnut Creek - Pedi-Pulmonary Satellite
Type
Children's Hospital
Rural
No
340B ID
PED053301-33
Medicare Provider Number
053301
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/1/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/8/2024
Last Recertification Date
Contacts
Authorizing Official
UCSF Medical Center & Benioff Children's Hospital
James Wentz, SVP & CFO
(415) 514-6118
Primary Contact
UCSF Health
Kayla Hubbard, 340B Program Coordinator
(808) 339-5697
Addresses
Street Address
2401 Shadelands Dr
Walnut Creek, CA 94598-2412
Billing Address
UCSF Benioff Childrens Hospital Oakland
747 52nd Street
Oakland, CA 94609
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2019, terminated 10/1/2021. Reinstated 10/1/2024.
07/02/2024
June 2025
June 2025
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