Healthcare Provider Details
I. General information
NPI: 1861017204
Provider Name (Legal Business Name): BAY AREA COMMUNITY RESOURCES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2020
Last Update Date: 07/22/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2301 RANGE RD
PITTSBURG CA
94565-4646
US
IV. Provider business mailing address
11175 SAN PABLO AVE
EL CERRITO CA
94530-2157
US
V. Phone/Fax
- Phone: 925-473-2480
- Fax:
- Phone: 510-559-3009
- Fax: 510-559-3069
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
HOCHMAN
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 510-559-3012