Healthcare Provider Details

I. General information

NPI: 1780521575
Provider Name (Legal Business Name): DEVELOPING ORGANIZING VISIONS FOR EVERYONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 FAIRGROUNDS DR STE D
VALLEJO CA
94589-2076
US

IV. Provider business mailing address

2635 NAPA ST UNIT 1174
VALLEJO CA
94590-5653
US

V. Phone/Fax

Practice location:
  • Phone: 510-910-2675
  • Fax:
Mailing address:
  • Phone: 510-910-2675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. CAMERON DEWITT CLARK
Title or Position: EXECUTIVE DIRECTOR
Credential: CCAPP
Phone: 510-910-2675