| Elda | |
|
2334 Buchanan Rd Ste 2356 Antioch CA 94509-4411 | |
| (925) 436-8766 | |
| Not Available |
| Full Name | Elda |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2334 Buchanan Rd Ste 2356, Antioch, California |
| Authorized Official Name and Position | Jonta Laron Davenport (CEO) |
| Authorized Official Contact | 5107591320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elda 4400 Glen Canyon Cir Pittsburg CA 94565-6458 Ph: (510) 759-1320 | Elda 2334 Buchanan Rd Ste 2356 Antioch CA 94509-4411 Ph: (925) 436-8766 |
| NPI Number | 1861090086 |
|---|---|
| Provider Enumeration Date | 10/09/2020 |
| Last Update Date | 10/09/2020 |
| Certification Date | 10/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861090086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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