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Organization
MOMENTUM FOR MENTAL HEALTH - A.S.S.I.S.T. SOLANO OUTPATIENT
Active
Organization
MOMENTUM FOR MENTAL HEALTH - A.S.S.I.S.T. SOLANO OUTPATIENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S. SMELSER (CHIEF FINANCIAL OFFICER)
(408) 261-7777
Entity
Organization
Contact information
Practice address
1935 KIDDER AVE, FAIRFIELD, CA 94533-3919
(707) 425-2741
(707) 425-2862
Mailing address
2001 THE ALAMEDA, SAN JOSE, CA 95126-1136
(408) 261-7777
(408) 554-9960
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48AS
—
CA
Enumeration date
04/20/2007
Last updated
08/06/2008
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