| Azul Center For Integration | |
|
186 Isle Royal Circle Vacaville CA 95687 | |
| (707) 430-1376 | |
| Not Available |
| Full Name | Azul Center For Integration |
|---|---|
| Speciality | Early Intervention Provider Agency |
| Location | 186 Isle Royal Circle, Vacaville, California |
| Authorized Official Name and Position | Maria Carmen Covarrubias (CEO/CLINICAL DIRECTOR) |
| Authorized Official Contact | 5593135177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Azul Center For Integration 2010a Harbison Dr # 233 Vacaville CA 95687-3900 Ph: (559) 313-5177 | Azul Center For Integration 186 Isle Royal Circle Vacaville CA 95687 Ph: (707) 430-1376 |
| NPI Number | 1992311815 |
|---|---|
| Provider Enumeration Date | 09/16/2020 |
| Last Update Date | 09/16/2020 |
| Certification Date | 09/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992311815 | NPI | - | NPPES |
| 1528425584 | Other | NPI REGISTRY | |
| 1-15-19396 | Other | BCBA CERTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Primary |
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