Basic Information
| Provider Information | |||||||||
| NPI: | 1801370853 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAY AREA CLINICAL ASSOCIATES, P.C. | ||||||||
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| OtherOrganizationName: | BAY AREA CLINICAL ASSOCIATES, P.C. OAKLAND IOP | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1175 SARATOGA AVE STE 14 | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951293427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4089967950 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3010 COLBY ST STE 221 | ||||||||
| Address2: | |||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947052056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5109229757 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2018 | ||||||||
| LastUpdateDate: | 08/19/2019 | ||||||||
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| AuthorizedOfficialLastName: | MUNIZ | ||||||||
| AuthorizedOfficialFirstName: | BRANDI | ||||||||
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| AuthorizedOfficialTitleorPosition: | FINANCE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4089967950 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BAY AREA CLINICAL ASSOCIATES, P.C. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | 261QM0801X | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.