Healthcare Provider Details

I. General information

NPI: 1265553465
Provider Name (Legal Business Name): UJIMA FAMILY RECOVER SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E. LELAND RD. SUITES A&B
PITTSBURG CA
94565-4949
US

IV. Provider business mailing address

1901 CHURCH LANE
SAN PABLO CA
94806-3707
US

V. Phone/Fax

Practice location:
  • Phone: 925-427-9100
  • Fax: 925-427-9102
Mailing address:
  • Phone: 510-236-3139
  • Fax: 510-236-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number070008EN
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. RITA SCHANK
Title or Position: EXECUTIVE DIRECTOR
Credential: MPA
Phone: 510-236-3139