Provider Demographics
NPI:1003360538
Name:CONTRA COSTA COUNTY BEHAVIORAL HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:CONTRA COSTA COUNTY BEHAVIORAL HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICUM STUDENT TRAINEE
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:VERNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-866-5231
Mailing Address - Street 1:45 ALLSTON WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1101
Mailing Address - Country:US
Mailing Address - Phone:415-866-5231
Mailing Address - Fax:
Practice Address - Street 1:45 ALLSTON WAY
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1101
Practice Address - Country:US
Practice Address - Phone:415-866-5231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health