| Mental Health- Riverside | |
|
1300 Amador St San Pablo CA 94806-4094 | |
| (510) 231-1409 | |
| (510) 237-6991 |
| Full Name | Mental Health- Riverside |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1300 Amador St, San Pablo, California |
| Authorized Official Name and Position | Donald Bruce Blasky (CHIEF PROGRAM OFFICER) |
| Authorized Official Contact | 4157552311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health- Riverside 11175 San Pablo Ave El Cerrito CA 94530-2157 Ph: (510) 559-3009 | Mental Health- Riverside 1300 Amador St San Pablo CA 94806-4094 Ph: (510) 231-1409 |
| NPI Number | 1124581004 |
|---|---|
| Provider Enumeration Date | 04/09/2019 |
| Last Update Date | 08/02/2021 |
| Certification Date | 08/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124581004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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