Organization
BAY PEDIATRIC DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANAMERCEDES YEGANEH (PROGRAM DIRECTOR)
(415) 579-2731
Entity
Organization
Contact information
Practice address
111 DEERWOOD RD STE 395, SAN RAMON, CA 94583-1530
(415) 895-0207
Mailing address
111 DEERWOOD RD STE 395, SAN RAMON, CA 94583-1530
(415) 895-0207
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFC32136
CA
252Y00000X
Early Intervention Provider Agency
MFC32136
CA
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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