Healthcare Provider Details

I. General information

NPI: 1619494044
Provider Name (Legal Business Name): BAY AREA CLINICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 CAMPISI WAY STE 150
CAMPBELL CA
95008-2365
US

IV. Provider business mailing address

3010 COLBY ST STE 221
BERKELEY CA
94705-2056
US

V. Phone/Fax

Practice location:
  • Phone: 408-996-7950
  • Fax:
Mailing address:
  • Phone: 408-996-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MARY BETH PURI
Title or Position: DIRECTOR OF OPERATIONS
Credential: LPCC
Phone: 208-250-2724