Provider Demographics
NPI:1720164809
Name:MCCALL, MARIPOSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIPOSA
Middle Name:
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTRAL COUNTY ADULT BEHAVIORAL HEALTH
Mailing Address - Street 2:1420 WILLOW PASS RD, STE 200
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520
Mailing Address - Country:US
Mailing Address - Phone:925-646-5480
Mailing Address - Fax:925-649-5622
Practice Address - Street 1:CENTRAL COUNTY ADULT BEHAVIORAL HEALTH
Practice Address - Street 2:1420 WILLOW PASS RD, STE 200
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520
Practice Address - Country:US
Practice Address - Phone:925-646-5480
Practice Address - Fax:925-649-5622
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA756362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFQHC 05-1063OtherMEDICARE PART A
CAFQHC ZZZ29799ZOtherMEDICARE PART B