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13585 San Pablo Avenue 1st Floor San Pablo CA 94806 | |
(510) 942-4600 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 13585 San Pablo Avenue, San Pablo, California |
Authorized Official Name and Position | Patrick M. Godley (COO CFO) |
Authorized Official Contact | 9259575405 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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50 Douglas Dr Suite 391 Martinez CA 94553-4098 Ph: () - | 13585 San Pablo Avenue 1st Floor San Pablo CA 94806 Ph: (510) 942-4600 |
NPI Number | 1508936188 |
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Provider Enumeration Date | 11/09/2006 |
Last Update Date | 12/27/2021 |
Certification Date | 12/22/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508936188 | NPI | - | NPPES |
0768 | Other | CA | MENTAL HEALTH |
Taxonomy | Type | License (State) | Status |
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261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
Tri-cities Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2523 El Portal Dr Ste 206, San Pablo, CA 94806 Phone: 510-374-7017 | |
Rectory Womens Recovery Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 Church Ln, San Pablo, CA 94806 Phone: 510-236-3139 Fax: 510-236-3200 | |