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4892 San Pablo Dam Rd El Sobrante CA 94803-3222 | |
(510) 222-0292 | |
(510) 222-6731 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 4892 San Pablo Dam Rd, El Sobrante, California |
Authorized Official Name and Position | Donovan Grant (CFO) |
Authorized Official Contact | 5102220292 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 21330 El Sobrante CA 94820-1330 Ph: (510) 222-0292 | 4892 San Pablo Dam Rd El Sobrante CA 94803-3222 Ph: (510) 222-0292 |
NPI Number | 1134251069 |
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Provider Enumeration Date | 03/09/2007 |
Last Update Date | 04/17/2023 |
Certification Date | 04/17/2023 |
Identifier | Type | State | Issuer |
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1134251069 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |