Organization
HIAWATHA HARRIS MD INC
Active
Other names
Pathways To Wellness Medication Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NEISHA BECTON (CEO)
(925) 520-0005
Entity
Organization
Contact information
Practice address
5674 STONERIDGE DR, SUITE 205, PLEASANTON, CA 94588-8500
(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
103T00000X
Psychologist
Primary
C22371
CA
103TC2200X
Clinical Child & Adolescent Psychologist
C22371
CA
103TF0000X
Family Psychologist
C22371
CA
106H00000X
Marriage & Family Therapist
C22371
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01ED
—
CA
Enumeration date
02/14/2007
Last updated
08/02/2011
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