| Seneca Family Of Agencies | |
|
2275 Arlington Dr San Leandro CA 94578-1132 | |
| (510) 317-1446 | |
| Not Available |
| Full Name | Seneca Family Of Agencies |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2275 Arlington Dr, San Leandro, California |
| Authorized Official Name and Position | Scott Osborn (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5105200943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seneca Family Of Agencies 2275 Arlington Dr San Leandro CA 94578-1132 Ph: (510) 317-1446 | Seneca Family Of Agencies 2275 Arlington Dr San Leandro CA 94578-1132 Ph: (510) 317-1446 |
| NPI Number | 1114001906 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 02/22/2023 |
| Certification Date | 02/22/2023 |
| Medicare PECOS PAC ID | 7416145594 |
|---|---|
| Medicare Enrollment ID | O20110713000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114001906 | NPI | - | NPPES |
| 0015 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
| 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | (California) | Secondary |
| Provider Name | Sarita P Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609844539 PECOS PAC ID: 8426020827 Enrollment ID: I20110930000072 |
| Provider Name | Alys C Larsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952595092 PECOS PAC ID: 8628232477 Enrollment ID: I20120607000571 |
| Provider Name | Heidi S Allison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417174095 PECOS PAC ID: 7618131905 Enrollment ID: I20120618000623 |
| Provider Name | Julie Kwon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497028468 PECOS PAC ID: 1153585450 Enrollment ID: I20120618000642 |
| Provider Name | Amy C Blair |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699949727 PECOS PAC ID: 6103075684 Enrollment ID: I20120926000607 |
| Provider Name | Marybeth Fox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174684674 PECOS PAC ID: 6709024029 Enrollment ID: I20130529000029 |
| Provider Name | Kory D Stotesbery |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821250564 PECOS PAC ID: 8527212620 Enrollment ID: I20140905001702 |
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