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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