Healthcare Provider Details

I. General information

NPI: 1689025835
Provider Name (Legal Business Name): PATHWAYS TO WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5674 STONERIDGE DR
PLEASANTON CA
94588-8500
US

IV. Provider business mailing address

5674 STONERIDGE DR
PLEASANTON CA
94588-8500
US

V. Phone/Fax

Practice location:
  • Phone: 925-520-0005
  • Fax:
Mailing address:
  • Phone: 925-520-0005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RUTH NUNEZ
Title or Position: CLINICAL PROGRAM MANAGER
Credential:
Phone: 925-520-0005