Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 115 Flame Dr, Pacheco, California |
Authorized Official Name and Position | Gloria Jean Sandoval (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9256030112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1410 Danzig Plz 2nd. Floor Concord CA 94520-7979 Ph: (925) 603-0112 | 115 Flame Dr Pacheco CA 94553-5521 Ph: (925) 603-0112 |
NPI Number | 1801949797 |
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Provider Enumeration Date | 01/22/2007 |
Last Update Date | 08/18/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801949797 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |