Provider Demographics
NPI:1700405255
Name:CONTRA COSTA MH WELLNESS CENTER
Entity Type:Organization
Organization Name:CONTRA COSTA MH WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BIEDA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MFT
Authorized Official - Phone:800-619-8154
Mailing Address - Street 1:1320 WILLOW PASS RD STE 600
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5292
Mailing Address - Country:US
Mailing Address - Phone:800-619-8154
Mailing Address - Fax:800-619-8154
Practice Address - Street 1:1320 WILLOW PASS RD STE 600
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5292
Practice Address - Country:US
Practice Address - Phone:800-619-8154
Practice Address - Fax:800-619-8154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty