MEDICARE: UNIQUE CHARLISHA TODD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	106H00000X	Marriage & Family Therapist	142176	CA

General Provider Information

NPI Number	:	1093282444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UNIQUE CHARLISHA TODD

Provider Business Mailing Address
First Line	:	3445 WILLOW PASS RD
Second Line	:
City	:	BAY POINT
State	:	CA
Zip	:	94565-3144
Country	:	US
Telephone Number	:	925-864-5866
Fax Number	:

Provider Business Practice Location Address
First Line	:	3445 WILLOW PASS RD
Second Line	:
City	:	BAY POINT
State	:	CA
Zip	:	94565-3144
Country	:	US
Telephone Number	:	925-864-5866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2018
Last Update Date	:	11/03/2025

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Directions to “ UNIQUE CHARLISHA TODD ” Practice Location

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