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Organization
HIAWATHA HARRIS, CORPORATION
Active
Organization
HIAWATHA HARRIS, CORPORATION
Active
Other names
Pathways To Wellness Medication Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
NEISHA BECTON (C.E.O.)
(925) 520-0005
Entity
Organization
Contact information
Practice address
1210 ALHAMBRA AVE, MARTINEZ, CA 94553-2314
(925) 520-0005
(925) 520-0010
Mailing address
5674 STONERIDGE DR, SUITE 207, PLEASANTON, CA 94588-8500
(925) 520-0005
(925) 520-0010
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
C22371
CA
103TF0000X
Family Psychologist
C22371
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
C22371
CA
106H00000X
Marriage & Family Therapist
C22371
CA
Other
Enumeration date
05/16/2007
Last updated
07/08/2011
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