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301 Farragut Ave Vallejo CA 94590-4309 | |
(510) 909-9898 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 301 Farragut Ave, Vallejo, 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) 317-1144 | 301 Farragut Ave Vallejo CA 94590-4309 Ph: (510) 909-9898 |
NPI Number | 1962532143 |
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Provider Enumeration Date | 03/06/2007 |
Last Update Date | 07/25/2022 |
Certification Date | 07/25/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962532143 | NPI | - | NPPES |
0015 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (California) | Primary |
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