Provider Demographics
NPI:1497028815
Name:CLAREMONT BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:CLAREMONT BEHAVIORAL SERVICES
Other - Org Name:CLAREMONT EAP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:510-995-1109
Mailing Address - Street 1:1050 MARINA VILLAGE PKWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1099
Mailing Address - Country:US
Mailing Address - Phone:510-995-1109
Mailing Address - Fax:
Practice Address - Street 1:1050 MARINA VILLAGE PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1099
Practice Address - Country:US
Practice Address - Phone:510-995-1109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health