| Pathways To Wellness, Medication Clinic | |
|
1970 Broadway Ste 250 Oakland CA 94612-2214 | |
| (510) 273-4200 | |
| (510) 273-8340 |
| Full Name | Pathways To Wellness, Medication Clinic |
|---|---|
| Speciality | Counselor |
| Location | 1970 Broadway Ste 250, Oakland, California |
| Authorized Official Name and Position | Neisha Becton (CEO) |
| Authorized Official Contact | 9255200005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathways To Wellness, Medication Clinic 5674 Stoneridge Dr Suite 207 Pleasanton CA 94588-8500 Ph: (925) 520-0005 | Pathways To Wellness, Medication Clinic 1970 Broadway Ste 250 Oakland CA 94612-2214 Ph: (510) 273-4200 |
| NPI Number | 1942420724 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 08/16/2024 |
| Certification Date | 08/16/2024 |
| Medicare PECOS PAC ID | 1052580115 |
|---|---|
| Medicare Enrollment ID | O20110805000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942420724 | NPI | - | NPPES |
| 01AG | Medicaid | CA |
| Provider Name | Gilda R Versales |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720172554 PECOS PAC ID: 6406828532 Enrollment ID: I20040810000477 |
| Provider Name | Uday Mukherjee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659457075 PECOS PAC ID: 5496668436 Enrollment ID: I20041014000632 |
| Provider Name | Timothy R Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720208424 PECOS PAC ID: 8224010467 Enrollment ID: I20041015000649 |
| Provider Name | Tracie D Harvey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013970037 PECOS PAC ID: 0345293262 Enrollment ID: I20050302000807 |
| Provider Name | Lester E Love |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366687469 PECOS PAC ID: 0648295907 Enrollment ID: I20051006000324 |
| Provider Name | Hamid Q Sial |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003911637 PECOS PAC ID: 0042227118 Enrollment ID: I20060314000718 |
| Provider Name | Barrett G Levine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114087533 PECOS PAC ID: 2860595634 Enrollment ID: I20070315000276 |
| Provider Name | Yasin Mansoor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760448054 PECOS PAC ID: 7416855838 Enrollment ID: I20081008000583 |
| Provider Name | Marina Obolnikov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174732713 PECOS PAC ID: 6305904988 Enrollment ID: I20081027000228 |
| Provider Name | Gwendolyn Rothman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770525370 PECOS PAC ID: 7315084209 Enrollment ID: I20091026000622 |
| Provider Name | William Yee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043259690 PECOS PAC ID: 2163589292 Enrollment ID: I20100928000393 |
| Provider Name | Alka Aneja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619031317 PECOS PAC ID: 8123111614 Enrollment ID: I20110112000705 |
| Provider Name | Ruben Ruiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235297318 PECOS PAC ID: 4385826320 Enrollment ID: I20110311000231 |
| Provider Name | Barbara J Saunders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144365149 PECOS PAC ID: 6305023037 Enrollment ID: I20110607000351 |
| Provider Name | Hiawatha Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780722488 PECOS PAC ID: 1456520519 Enrollment ID: I20110819000177 |
| Provider Name | Armando Medina Braganza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962565416 PECOS PAC ID: 0749339919 Enrollment ID: I20140429002368 |
| Provider Name | Mudassir S Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245278548 PECOS PAC ID: 5395792550 Enrollment ID: I20140708002556 |
| Provider Name | Elizabeth Mole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376979237 PECOS PAC ID: 3476863119 Enrollment ID: I20160218000248 |
| Provider Name | Carolyn D Harris-muchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619155280 PECOS PAC ID: 2567751878 Enrollment ID: I20160510000661 |
| Provider Name | Joan Alviar Fraino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487025375 PECOS PAC ID: 6608167978 Enrollment ID: I20160616000164 |
| Provider Name | Lewis A Vanosdel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417000852 PECOS PAC ID: 3072764257 Enrollment ID: I20170608002400 |
| Provider Name | Susan Y Shen |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1730422502 PECOS PAC ID: 2264700038 Enrollment ID: I20170620001203 |
| Provider Name | Lisa Torre-igwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851442529 PECOS PAC ID: 2769755370 Enrollment ID: I20170901001921 |
| Provider Name | Blessing Lawski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326494337 PECOS PAC ID: 8426323536 Enrollment ID: I20170928003464 |
| Provider Name | Amber Aguilar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942750393 PECOS PAC ID: 9638413404 Enrollment ID: I20181205000769 |
| Provider Name | Adenike C. Ogunleye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740813062 PECOS PAC ID: 4587086152 Enrollment ID: I20200629000299 |
| Provider Name | Sridevi Banka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477199420 PECOS PAC ID: 6608296231 Enrollment ID: I20201020000791 |
| Provider Name | Shararah Aziz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023524691 PECOS PAC ID: 6507279908 Enrollment ID: I20210104000390 |
| Provider Name | Douglas Logan Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386240844 PECOS PAC ID: 6103230479 Enrollment ID: I20210127002643 |
| Provider Name | Charlene Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871181180 PECOS PAC ID: 5890183818 Enrollment ID: I20211025002228 |
| Provider Name | Siavash Rostami Jafarabad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265993299 PECOS PAC ID: 4880080365 Enrollment ID: I20220410000024 |
| Provider Name | Ronak Soliemannjad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114616992 PECOS PAC ID: 2264875855 Enrollment ID: I20240212000520 |
| Provider Name | Malaika Alert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679242481 PECOS PAC ID: 4082055413 Enrollment ID: I20240515003654 |
| Provider Name | Evan J Trager |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821484718 PECOS PAC ID: 3678914017 Enrollment ID: I20240515004403 |
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