Provider Demographics
NPI:1265765515
Name:Y.W.C.A. OF CONTRA COSTA/ SAC. COUNTY
Entity type:Organization
Organization Name:Y.W.C.A. OF CONTRA COSTA/ SAC. COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHIAVO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MF C #45077
Authorized Official - Phone:925-372-4213
Mailing Address - Street 1:1320 ARNOLD DR STE 170
Mailing Address - Street 2:
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 1:1320 ARNOLD DR STE 170
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-6537
Practice Address - Country:US
Practice Address - Phone:925-372-4213
Practice Address - Fax:925-372-4216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45077106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty