Healthcare Provider Details

I. General information

NPI: 1083069447
Provider Name (Legal Business Name): BAY AREA COMMUNITY RESOURCES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11175 SAN PABLO AVE
EL CERRITO CA
94530-2157
US

IV. Provider business mailing address

11175 SAN PABLO AVE
EL CERRITO CA
94530-2157
US

V. Phone/Fax

Practice location:
  • Phone: 510-559-3009
  • Fax: 510-559-3069
Mailing address:
  • Phone: 510-559-3009
  • Fax: 510-559-3069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DONALD BRUCE BLASKY
Title or Position: ED BEHAVIORAL HEALTH
Credential: LMFT
Phone: 415-302-3685