Provider Demographics
NPI:1346682515
Name:BIBETT
Entity Type:Organization
Organization Name:BIBETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:RAS
Authorized Official - Phone:925-798-7250
Mailing Address - Street 1:2290 DIAMOND BLVD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5742
Mailing Address - Country:US
Mailing Address - Phone:925-798-7250
Mailing Address - Fax:925-798-3359
Practice Address - Street 1:3726 BARRETT AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-2253
Practice Address - Country:US
Practice Address - Phone:510-215-2402
Practice Address - Fax:510-215-2799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070001DDN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health