Healthcare Provider Details

I. General information

NPI: 1164543294
Provider Name (Legal Business Name): CHOICE IN AGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 GOLF CLUB RD
PLEASANT HILL CA
94523-1553
US

IV. Provider business mailing address

490 GOLF CLUB RD
PLEASANT HILL CA
94523-1553
US

V. Phone/Fax

Practice location:
  • Phone: 925-682-6343
  • Fax: 925-682-6375
Mailing address:
  • Phone: 925-682-6343
  • Fax: 925-682-6375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number070000503
License Number StateCA

VIII. Authorized Official

Name: LORI THAMES
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 925-682-6330