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1060 Manor Rd El Sobrante CA 94803-1336 | |
(510) 654-4004 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 1060 Manor Rd, El Sobrante, California |
Authorized Official Name and Position | Sandy Hobson (QUALITY ASSURANCE DIRECTOR) |
Authorized Official Contact | 5107255727 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2275 Arlington Dr San Leandro CA 94578-1132 Ph: (510) 654-4004 | 1060 Manor Rd El Sobrante CA 94803-1336 Ph: (510) 654-4004 |
NPI Number | 1205189776 |
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Provider Enumeration Date | 10/22/2012 |
Last Update Date | 09/07/2022 |
Certification Date | 09/07/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205189776 | NPI | - | NPPES |
0015 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |