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General NPI Number Information
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NPI Number | 1003955600
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Entity Type | Organization
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Legal Business Name | AMADOR INSTITUTE
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3701 LONE TREE WAY STE 7AND4A
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City | ANTIOCH
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State | CA
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Zip | 94509-6038
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Country | US
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Telephone | 925-778-3800
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Fax | 925-778-3915
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Provider Business Mailing Address
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Address Line | 3701 LONE TREE WAY, STE. 7 AND 4A
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City | ANTIOCH
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State | CA
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Zip | 94509
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Country | US
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Telephone | 925-778-3800
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Fax | 925-778-3915
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. PATSY LEE PHILLIPS
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Credential | LMFT
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Telephone | 925-778-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFC22411
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License Number State | CA
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