Healthcare Provider Details

I. General information

NPI: 1528985967
Provider Name (Legal Business Name): B2 ELEVATED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 JOHN MUIR PKWY
HERCULES CA
94547-2790
US

IV. Provider business mailing address

1840 JOHN MUIR PKWY
HERCULES CA
94547-2790
US

V. Phone/Fax

Practice location:
  • Phone: 510-612-5019
  • Fax:
Mailing address:
  • Phone: 510-612-5019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: BRYAN BISHOP
Title or Position: DIRECTOR
Credential: CSP, OHST
Phone: 510-612-5019