| |
39155 Liberty St Ste F600 Fremont CA 94538-1513 | |
(510) 300-3500 | |
(510) 291-9591 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 39155 Liberty St Ste F600, Fremont, California |
Authorized Official Name and Position | Virginia Elizabeth Salvatier (ADMINISTRATO AND OPERATIONS MANAGER) |
Authorized Official Contact | 5103003516 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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24301 Southland Dr Ste 300 Hayward CA 94545-1546 Ph: (510) 300-3516 | 39155 Liberty St Ste F600 Fremont CA 94538-1513 Ph: (510) 300-3500 |
NPI Number | 1578125076 |
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Provider Enumeration Date | 07/03/2019 |
Last Update Date | 08/17/2020 |
Certification Date | 08/17/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578125076 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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