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General NPI Number Information
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NPI Number | 1639701857
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Entity Type | Organization
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Legal Business Name | JOURNEY TO NEW BEGINNINGS
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 1807 SANTA RITA RD UNIT H188
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City | PLEASANTON
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State | CA
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Zip | 94566-4779
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Country | US
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Telephone | 92-540-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 1807 SANTA RITA RD UNIT H188
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City | PLEASANTON
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State | CA
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Zip | 94566-4779
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Country | US
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Telephone | 92-540-0333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE ACOSTA
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Credential |
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Telephone | 925-400-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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