Provider Demographics
NPI:1528215894
Name:ASIAN COMMUNITY MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:ASIAN COMMUNITY MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERN
Authorized Official - Prefix:MR
Authorized Official - First Name:KENICHI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKAHASHI
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:925-639-0380
Mailing Address - Street 1:3181 CAFETO DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3842
Mailing Address - Country:US
Mailing Address - Phone:925-639-0380
Mailing Address - Fax:
Practice Address - Street 1:310 8TH ST
Practice Address - Street 2:201
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-6526
Practice Address - Country:US
Practice Address - Phone:510-451-6729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5822273561OtherOVERSEAS TRAVEL INSURANCE