Organization
HIAWATHA HARRIS, CORPORATION
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
509 W 10TH ST, ANTIOCH, CA 94509-1653
(925) 706-1510
(925) 892-9822
Mailing address
5674 STONERIDGE DR STE 207, PLEASANTON, CA 94588-8592
(925) 520-0005
(925) 520-0010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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