Healthcare Provider Details

I. General information

NPI: 1427974161
Provider Name (Legal Business Name): CHAD GINGERY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 OAK GROVE RD STE C
CONCORD CA
94518-3225
US

IV. Provider business mailing address

1340 ARNOLD DR STE 200
MARTINEZ CA
94553-4189
US

V. Phone/Fax

Practice location:
  • Phone: 925-381-1019
  • Fax:
Mailing address:
  • Phone: 925-957-5110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-WDHLJE
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: