Healthcare Provider Details

I. General information

NPI: 1346674850
Provider Name (Legal Business Name): DIABLO VALLEY DRUG AND ALCOHOL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 10/13/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PARK PL # 120
SAN RAMON CA
94583-4460
US

IV. Provider business mailing address

111 DEERWOOD RD STE 235
SAN RAMON CA
94583-4409
US

V. Phone/Fax

Practice location:
  • Phone: 925-289-1430
  • Fax: 925-362-0174
Mailing address:
  • Phone: 925-289-1430
  • Fax: 925-231-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberA86415
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL SMEESTER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 925-640-5441