Provider Demographics
NPI:1104968775
Name:CONTRA COSTA HEALTH SERVICES
Entity type:Organization
Organization Name:CONTRA COSTA HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:DARNELL
Authorized Official - Last Name:DEVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-374-7500
Mailing Address - Street 1:2523 EL PORTAL DR
Mailing Address - Street 2:SUITE #103
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3305
Mailing Address - Country:US
Mailing Address - Phone:510-374-7398
Mailing Address - Fax:510-374-7504
Practice Address - Street 1:2523 EL PORTAL DR
Practice Address - Street 2:SUITE #103
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3305
Practice Address - Country:US
Practice Address - Phone:510-374-7500
Practice Address - Fax:510-374-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1839OtherMENTAL HEALTH