Provider Demographics
NPI:1235545559
Name:CONTRA COSTA COUNTY
Entity Type:Organization
Organization Name:CONTRA COSTA COUNTY
Other - Org Name:FORENSIC MENTAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:DE CESARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-957-5429
Mailing Address - Street 1:50 DOUGLAS DR
Mailing Address - Street 2:SUITE 310-E
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4098
Mailing Address - Country:US
Mailing Address - Phone:925-957-5429
Mailing Address - Fax:
Practice Address - Street 1:1430 WILLOW PASS RD
Practice Address - Street 2:SUITE 100 AND 105
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-7928
Practice Address - Country:US
Practice Address - Phone:925-957-5429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health