| The Bloom | |
|
2010 Crow Canyon Pl Ste 100 San Ramon CA 94583-1344 | |
| (925) 678-4010 | |
| Not Available |
| Full Name | The Bloom |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2010 Crow Canyon Pl Ste 100, San Ramon, California |
| Authorized Official Name and Position | Jenny Lee (OWNER) |
| Authorized Official Contact | 9256784010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Bloom 920 Bayswater Ave Apt 208 Burlingame CA 94010-3137 Ph: () - | The Bloom 2010 Crow Canyon Pl Ste 100 San Ramon CA 94583-1344 Ph: (925) 678-4010 |
| NPI Number | 1346003381 |
|---|---|
| Provider Enumeration Date | 02/01/2024 |
| Last Update Date | 02/01/2024 |
| Certification Date | 02/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346003381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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