Provider Demographics
NPI:1346674850
Name:DIABLO VALLEY DRUG AND ALCOHOL SERVICES INC.
Entity type:Organization
Organization Name:DIABLO VALLEY DRUG AND ALCOHOL SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMEESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-640-5441
Mailing Address - Street 1:111 DEERWOOD RD STE 235
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4409
Mailing Address - Country:US
Mailing Address - Phone:925-289-1430
Mailing Address - Fax:925-231-7073
Practice Address - Street 1:100 PARK PL # 120
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4460
Practice Address - Country:US
Practice Address - Phone:925-289-1430
Practice Address - Fax:925-362-0174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2024-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86415261QH0100X
261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service