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604 Broadway St Vallejo CA 94590-3323 | |
(707) 643-2748 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 604 Broadway St, Vallejo, California |
Authorized Official Name and Position | Susan Jeanne Cinelli (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9257987250 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2290 Diamond Blvd Suite 205 Concord CA 94520 Ph: (925) 798-7250 | 604 Broadway St Vallejo CA 94590-3323 Ph: (707) 643-2748 |
NPI Number | 1649692971 |
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Provider Enumeration Date | 01/06/2014 |
Last Update Date | 01/06/2014 |
Identifier | Type | State | Issuer |
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1649692971 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | A8740313 (California) | Primary |
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