MEDICARE: YWCA OF CONTRA COSTA & SACRAMENTO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184761017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YWCA OF CONTRA COSTA & SACRAMENTO

Provider Business Mailing Address
First Line	:	1320 ARNOLD DR
Second Line	:	SUITE 170
City	:	MARTINEZ
State	:	CA
Zip	:	94553-6537
Country	:	US
Telephone Number	:	925-372-4213
Fax Number	:	925-372-4216

Provider Business Practice Location Address
First Line	:	1320 ARNOLD DR
Second Line	:	SUITE 170
City	:	MARTINEZ
State	:	CA
Zip	:	94553-6537
Country	:	US
Telephone Number	:	925-372-4213
Fax Number	:	925-372-4216

Authorized Official
Title or Position	:	CEO
Name	:	MS. NANCY J ATKINSON
Credential	:	MFT
Telephone Number	:	925-372-4213

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	08/22/2020

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