Healthcare Provider Details

I. General information

NPI: 1952983546
Provider Name (Legal Business Name): NEXUS BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 04/23/2021
Certification Date: 04/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39899 BALENTINE DR
NEWARK CA
94560-5355
US

IV. Provider business mailing address

39899 BALENTINE DR
NEWARK CA
94560-5355
US

V. Phone/Fax

Practice location:
  • Phone: 510-626-9290
  • Fax: 844-447-0582
Mailing address:
  • Phone: 510-626-9290
  • Fax: 844-447-0582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: BEATRIZ CHAVEZ
Title or Position: DIRECTOR OF PRACTICE ADMINISTRATION
Credential:
Phone: 331-226-1261