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13201 San Pablo Ave Suite 205 San Pablo CA 94806-3952 | |
| (510) 235-2887 | |
| (510) 235-2563 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 13201 San Pablo Ave, 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 |
|---|---|
13201 San Pablo Ave Suite 205 San Pablo CA 94806-3952 Ph: (510) 235-2887 | 13201 San Pablo Ave Suite 205 San Pablo CA 94806-3952 Ph: (510) 235-2887 |
| NPI Number | 1083886485 |
|---|---|
| Provider Enumeration Date | 03/26/2008 |
| Last Update Date | 08/02/2021 |
| Certification Date | 08/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083886485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 990322 (California) | Primary |
Tri-cities Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2523 El Portal Dr Ste 206, San Pablo, CA 94806 Phone: 510-374-7017 | |
Rectory Womens Recovery Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 Church Ln, San Pablo, CA 94806 Phone: 510-236-3139 Fax: 510-236-3200 | |