Provider Demographics
NPI:1427138726
Name:CONTRA COSTA COUNTY
Entity type:Organization
Organization Name:CONTRA COSTA COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:GODLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-957-5405
Mailing Address - Street 1:50 DOUGLAS DRIVE
Mailing Address - Street 2:HEALTH SERVICES ADMINISTRATION SUITE 391
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4098
Mailing Address - Country:US
Mailing Address - Phone:925-957-5429
Mailing Address - Fax:925-957-5401
Practice Address - Street 1:2500 ALHAMBRA AVENUE
Practice Address - Street 2:CONTRA COSTA REGIONAL MEDICAL CENTER AND HEALTH CENTERS
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3156
Practice Address - Country:US
Practice Address - Phone:925-957-5429
Practice Address - Fax:925-957-5401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTRA COSTA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-17
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHSC00276Medicaid
CAHSC00276Medicaid