Provider Demographics
NPI:1558405035
Name:ASPIRA FOSTER & FAMILY SERVICES - ANTIOCH
Entity Type:Organization
Organization Name:ASPIRA FOSTER & FAMILY SERVICES - ANTIOCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-866-4080
Mailing Address - Street 1:3727 SUNSET LN STE 210
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6135
Mailing Address - Country:US
Mailing Address - Phone:925-753-2156
Mailing Address - Fax:925-753-2157
Practice Address - Street 1:3727 SUNSET LN STE 210
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6135
Practice Address - Country:US
Practice Address - Phone:925-753-2156
Practice Address - Fax:925-753-2157
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPIRANET
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-16
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA075200503251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health