Provider Demographics
NPI:1447602693
Name:CONTRA COSTA COUNTY
Entity Type:Organization
Organization Name:CONTRA COSTA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROPPETTI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:925-890-7540
Mailing Address - Street 1:4427 HORSESHOE CIR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8136
Mailing Address - Country:US
Mailing Address - Phone:925-457-1404
Mailing Address - Fax:
Practice Address - Street 1:4427 HORSESHOE CIR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8136
Practice Address - Country:US
Practice Address - Phone:925-457-1404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF80935252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIMF58260OtherMFTI