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General NPI Number Information
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NPI Number | 1700405255
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Entity Type | Organization
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Legal Business Name | CONTRA COSTA MH WELLNESS CENTER
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 1320 WILLOW PASS RD STE 600
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City | CONCORD
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State | CA
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Zip | 94520-5292
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Country | US
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Telephone | 800-619-8154
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Fax | 800-619-8154
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Provider Business Mailing Address
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Address Line | 1320 WILLOW PASS RD STE 600
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City | CONCORD
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State | CA
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Zip | 94520-5292
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Country | US
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Telephone | 800-619-8154
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Fax | 800-619-8154
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. JOHN CHARLES BIEDA JR.
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Credential | MFT
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Telephone | 800-619-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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