Healthcare Provider Details

I. General information

NPI: 1528733847
Provider Name (Legal Business Name): BAY AREA CLINICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2837 PRESIDIO DR STE 221
SAN DIEGO CA
92110-2722
US

IV. Provider business mailing address

1175 SARATOGA AVE STE 14
SAN JOSE CA
95129-3427
US

V. Phone/Fax

Practice location:
  • Phone: 619-241-2781
  • Fax: 619-906-5005
Mailing address:
  • Phone: 408-996-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BRANDI MUNIZ
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 408-996-7950