Provider Demographics
NPI:1811198773
Name:YWCA OF CONTRA COSTA COUNTY & SACRAMENTO
Entity Type:Organization
Organization Name:YWCA OF CONTRA COSTA COUNTY & SACRAMENTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:925-372-4213
Mailing Address - Street 1:1320 ARNOLD DR
Mailing Address - Street 2:SUITE
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-6537
Mailing Address - Country:US
Mailing Address - Phone:925-372-4213
Mailing Address - Fax:925-372-4216
Practice Address - Street 1:931 CAVALLO RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1971
Practice Address - Country:US
Practice Address - Phone:925-778-6234
Practice Address - Fax:925-372-4216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA97935Medicaid