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General NPI Number Information
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NPI Number | 1528721925
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Entity Type | Organization
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Legal Business Name | A&A HEALTH SERVICES SAN PABLO
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 13956 SAN PABLO AVE
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City | SAN PABLO
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State | CA
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Zip | 94806-5313
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Country | US
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Telephone | 415-710-7538
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 DANVILLE BLVD STE 256
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City | ALAMO
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State | CA
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Zip | 94507-1992
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Country | US
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Telephone | 415-710-7538
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BETTY BEATA DOMINICI
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Credential | CEO
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Telephone | 415-710-7538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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