Organization
KIVA SPIRIT FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATT GOMES PHD, LMFT (EXECUTIVE DIRECTOR)
(925) 485-9370
Entity
Organization
Contact information
Practice address
2222 2ND ST, SUITE 12, LIVERMORE, CA 94550-4554
(925) 485-9370
Mailing address
PO BOX 1424, PLEASANTON, CA 94566-0142
(925) 485-9370
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
CA
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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