| Full Name | Fa |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 315 G St, Antioch, California |
| Authorized Official Name and Position | Alexis Adorador (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5104125930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fa 315 G St Antioch CA 94509-1254 Ph: (925) 755-7775 | Fa 315 G St Antioch CA 94509-1254 Ph: (925) 755-7775 |
| NPI Number | 1922200799 |
|---|---|
| Provider Enumeration Date | 06/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922200799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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