San Quentin
NPI #1710329925 in Berkeley, California
Provider Information
- NPI Number
- 1710329925
- Entity Type
- Organization
- Organization Name
- San Quentin
- Primary Specialty
- Case Management
- Enumeration Date
- Jul 29, 2013
- Last Updated
- Jul 29, 2013
Practice Location
- Address
- 1635 JOSEPHINE ST
- City
- Berkeley
- State
- California
- ZIP Code
- 94703-1320
- Phone
- (415) 454-1469
Authorized Official
- Name
- MR. CHRISTOPHER ROACH, PSYCH. D
- Title
- SUPERVISOR
- Phone
- (415) 454-1460
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Management |
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