Healthcare Provider Details

I. General information

NPI: 1104761311
Provider Name (Legal Business Name): ABODE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 CAPITOL ST
VALLEJO CA
94590-5721
US

IV. Provider business mailing address

40849 FREMONT BLVD
FREMONT CA
94538-4306
US

V. Phone/Fax

Practice location:
  • Phone: 510-657-7409
  • Fax:
Mailing address:
  • Phone:
  • 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: SHERMAN WONG
Title or Position: QUALITY ASSURANCE COORDINATOR
Credential:
Phone: 510-270-1150