Healthcare Provider Details

I. General information

NPI: 1770142556
Provider Name (Legal Business Name): HOPE GROWS BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 06/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S BROADWAY STE 310
WALNUT CREEK CA
94596-5218
US

IV. Provider business mailing address

800 S BROADWAY STE 310
WALNUT CREEK CA
94596-5218
US

V. Phone/Fax

Practice location:
  • Phone: 888-531-8385
  • Fax: 925-264-1902
Mailing address:
  • Phone: 888-531-8385
  • Fax: 925-264-1902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: CHELSEY WHITWORTH
Title or Position: DIRECTOR OF OPERATIONS
Credential: MS
Phone: 925-405-5011