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General NPI Number Information
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NPI Number | 1588016984
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Entity Type | Organization
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Legal Business Name | BAY AREA INTEGRATIVE COUNSELING
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Dates
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Enumeration Date | 07/08/2016
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 842 CALIFORNIA ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-2315
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Country | US
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Telephone | 415-748-5421
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10434
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City | OAKLAND
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State | CA
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Zip | 94610-0434
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Country | US
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Telephone | 415-730-3164
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | NATHAN VILLARANTE
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Credential | LPCC INTERN
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Telephone | 415-748-5421
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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 | C3770323
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License Number State | CA
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