Provider Demographics
NPI:1396944310
Name:EMBRACE
Entity type:Organization
Organization Name:EMBRACE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY / CFO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:SALVESTRIN BERGESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-943-1794
Mailing Address - Street 1:3478 BUSKIRK AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4344
Mailing Address - Country:US
Mailing Address - Phone:925-943-1794
Mailing Address - Fax:925-943-6091
Practice Address - Street 1:3478 BUSKIRK AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4344
Practice Address - Country:US
Practice Address - Phone:925-943-1794
Practice Address - Fax:925-943-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health