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General NPI Number Information
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NPI Number | 1174743694
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Entity Type | Organization
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Legal Business Name | DIABLO BEHAVIORAL HEALTHCARE
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 4185 BLACKHAWK PLAZA CIR SUITE 210
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City | DANVILLE
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State | CA
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Zip | 94506-4694
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Country | US
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Telephone | 925-648-2650
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Fax | 925-648-2530
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Provider Business Mailing Address
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Address Line | PO BOX 1613
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City | DANVILLE
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State | CA
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Zip | 94526-6613
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Country | US
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Telephone | 925-648-4800
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Fax | 925-648-2530
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | SUSAN SHRYER
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Credential |
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Telephone | 925-648-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS 9942
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C29074
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | C32821
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C32821
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 14928
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 41716
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP 10617
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP 2994
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | LEP 2801
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License Number State | CA
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Taxonomy #10
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A104000
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License Number State | CA
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Taxonomy #11
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | A104000
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License Number State | CA
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