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1510 Via Sonya San Lorenzo CA 94580-2760 | |
| (510) 317-5000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1510 Via Sonya, San Lorenzo, California |
| Authorized Official Name and Position | Kent Dunlap (PRESIDENT AND CHIEF EXECUTIVE OFFIC) |
| Authorized Official Contact | 3102216336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
400 Estudillo Ave Ste 100 San Leandro CA 94577-4962 Ph: () - | 1510 Via Sonya San Lorenzo CA 94580-2760 Ph: (510) 317-5000 |
| NPI Number | 1902117450 |
|---|---|
| Provider Enumeration Date | 06/30/2010 |
| Last Update Date | 01/09/2025 |
| Certification Date | 01/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902117450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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