| Convergence Life | |
|
942 Cedarcrest Dr Vacaville CA 95687-7883 | |
| (503) 462-5388 | |
| Not Available |
| Full Name | Convergence Life |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 942 Cedarcrest Dr, Vacaville, California |
| Authorized Official Name and Position | Shane Clontz (MANAGING DIRECTOR) |
| Authorized Official Contact | 5034625388 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Convergence Life 942 Cedarcrest Dr Vacaville CA 95687-7883 Ph: (503) 462-5388 | Convergence Life 942 Cedarcrest Dr Vacaville CA 95687-7883 Ph: (503) 462-5388 |
| NPI Number | 1700608585 |
|---|---|
| Provider Enumeration Date | 10/31/2024 |
| Last Update Date | 10/31/2024 |
| Certification Date | 10/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700608585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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