Provider Demographics
NPI:1801370853
Name:BAY AREA CLINICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:BAY AREA CLINICAL ASSOCIATES, P.C.
Other - Org Name:BAY AREA CLINICAL ASSOCIATES, P.C. OAKLAND IOP
Other - Org Type:Other Name
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-996-7950
Mailing Address - Street 1:1175 SARATOGA AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3427
Mailing Address - Country:US
Mailing Address - Phone:408-996-7950
Mailing Address - Fax:
Practice Address - Street 1:3010 COLBY ST STE 221
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2056
Practice Address - Country:US
Practice Address - Phone:510-922-9757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA CLINICAL ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-16
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty