Basic Information
| Provider Information | |||||||||
| NPI: | 1972897346 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALDEA, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1546 1ST ST | ||||||||
| Address2: | |||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945592841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072248266 | ||||||||
| FaxNumber: | 7072248628 | ||||||||
| Practice Location | |||||||||
| Address1: | 470 CHADBOURNE RD | ||||||||
| Address2: | SUITE E | ||||||||
| City: | FAIRFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945349600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074259670 | ||||||||
| FaxNumber: | 7074259880 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2011 | ||||||||
| LastUpdateDate: | 05/13/2020 | ||||||||
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| AuthorizedOfficialLastName: | GRIFFIN | ||||||||
| AuthorizedOfficialFirstName: | DIANA | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 7072248266 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.