Healthcare Provider Details

I. General information

NPI: 1932341187
Provider Name (Legal Business Name): ANNEKE HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 04/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 GATEWAY
CONCORD CA
94520-3279
US

IV. Provider business mailing address

1850 GATEWAY BLVD
CONCORD CA
94520-3279
US

V. Phone/Fax

Practice location:
  • Phone: 925-825-4700
  • Fax:
Mailing address:
  • Phone: 925-825-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: