MEDICARE: BAY AREA CLINICAL ASSOCIATES, P.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	1041C0700X	Clinical Social Worker
3	106H00000X	Marriage & Family Therapist
4	2084P0804X	Child & Adolescent Psychiatry Physician

General Provider Information

NPI Number	:	1619494044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA CLINICAL ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	3010 COLBY ST STE 221
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2056
Country	:	US
Telephone Number	:	408-996-7950
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 CAMPISI WAY STE 150
Second Line	:
City	:	CAMPBELL
State	:	CA
Zip	:	95008-2365
Country	:	US
Telephone Number	:	408-996-7950
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MARY BETH PURI
Credential	:	LPCC
Telephone Number	:	208-250-2724

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	01/20/2026

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