NPIMap

Organization Active NPI

La Concordia Psychotherapy and Wellness Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Concord, CA
National Provider Identifier
1154933026
Registry record updated Sep 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LA CONCORDIA PSYCHOTHERAPY AND WELLNESS CLINIC
Practice address
1070 Concord Ave Ste 109
Concord, CA 94520-5608
Phone
(925) 849-5349
Fax
(925) 270-3382
NPI assigned
Aug 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Ruth Alejandra Fernandez, BS
Title
Office Manager
Phone
(925) 849-4695

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1070 Concord Ave Ste 109
Concord, CA 94520-5608

Mailing address

1070 Concord Ave Ste 109
Concord, CA 94520-5608
Phone (925) 849-5349

Other identifiers 3

IdentifierTypeStateIssuer
1750641189OtherCANPI
1558558676OtherCANPI
1588997035OtherCANPI

National Provider Directory

National Provider Directory

Locations

1070 Concord Ave
Ste 200
Concord, CA 94520
Phone (925) 300-8600

1070 Concord Ave
Ste 109
Concord, CA 94520
Phone (925) 849-5349

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600473600000",
    "number": "1154933026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 CONCORD AVE STE 109",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205608",
            "telephone_number": "925-849-5349",
            "fax_number": "925-270-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 CONCORD AVE STE 109",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205608",
            "telephone_number": "925-849-5349",
            "fax_number": "925-270-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CONCORDIA PSYCHOTHERAPY AND WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-09-19",
        "certification_date": "2020-09-19",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "ALEJANDRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "925-849-4695",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750641189",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1558558676",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1588997035",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.