Provider Demographics
NPI:1174677116
Name:CONTRA COSTA COUNTY HEALTH SERVICES
Entity Type:Organization
Organization Name:CONTRA COSTA COUNTY HEALTH SERVICES
Other - Org Name:CONTRA COSTA COUNTY MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MENTAL HEALTH PROG MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:925-646-5480
Mailing Address - Street 1:1420 WILLOW PASS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5223
Mailing Address - Country:US
Mailing Address - Phone:925-646-5480
Mailing Address - Fax:
Practice Address - Street 1:1420 WILLOW PASS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5223
Practice Address - Country:US
Practice Address - Phone:925-646-5480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 18702106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty