Healthcare Provider Details

I. General information

NPI: 1467220772
Provider Name (Legal Business Name): ACM MENTAL HEALTH AND WELLNESS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 OAKLAND BLVD STE 300
WALNUT CREEK CA
94596-8406
US

IV. Provider business mailing address

1407 OAKLAND BLVD STE 300
WALNUT CREEK CA
94596-8406
US

V. Phone/Fax

Practice location:
  • Phone: 719-357-7617
  • Fax: 925-357-9490
Mailing address:
  • Phone: 719-357-7617
  • Fax: 925-357-9490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARDIS C. MARTIN
Title or Position: OWNER/CEO
Credential: MD
Phone: 719-357-7617