Provider Demographics
NPI:1437406915
Name:COMMUNITY CENTER FOR HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:COMMUNITY CENTER FOR HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:650-855-8898
Mailing Address - Street 1:744 SAN ANTONIO RD
Mailing Address - Street 2:SUITE # 22/24
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4632
Mailing Address - Country:US
Mailing Address - Phone:650-855-8898
Mailing Address - Fax:
Practice Address - Street 1:744 SAN ANTONIO RD
Practice Address - Street 2:SUITE # 22/24
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4632
Practice Address - Country:US
Practice Address - Phone:650-855-8898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOFIA UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health