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Organization
TRI-CITIES
Active
Organization
TRI-CITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOROTHY HAYNES (DIRECTOR)
(510) 374-7011
Entity
Organization
Contact information
Practice address
5335 BAYVIEW AVE, RICHMOND, CA 94804-4911
(510) 374-7011
Mailing address
5335 BAYVIEW AVE, RICHMOND, CA 94804-4911
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
H0501041743
CA
Other
Enumeration date
05/08/2007
Last updated
08/22/2020
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