NPIMap

Organization Active NPI

Hiawatha Harris, Corporation

Doing business as Pathways to Wellness, Medication Clinic

  • Prescribing (Medical) Psychologist
  • Antioch, CA
National Provider Identifier
1396021150
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
Legal business name
HIAWATHA HARRIS, CORPORATION
Doing business as
Pathways to Wellness, Medication Clinic
Practice address
509 W 10TH St
Antioch, CA 94509-1653
Phone
(925) 706-1510
Fax
(925) 892-9822
NPI assigned
Oct 25, 2011
Last updated
Oct 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Authorized official

Name
Mrs. Neisha BectonNPI 1356522643
Title
Ceo
Phone
(925) 520-0005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Psychologist 103TC0700X NU
Prescribing (Medical) Psychologist 103TP0016X NU Primary

Addresses

Primary practice location

509 W 10TH St
Antioch, CA 94509-1653

Mailing address

5674 Stoneridge Dr Ste 207
Pleasanton, CA 94588-8592
Phone (925) 520-0005

Other names 1

  • Pathways to Wellness, Medication Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hiawatha Harris MD Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1396021150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5674 STONERIDGE DR STE 207",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888592",
            "telephone_number": "925-520-0005",
            "fax_number": "925-520-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W 10TH ST",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945091653",
            "telephone_number": "925-706-1510",
            "fax_number": "925-892-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIAWATHA HARRIS, CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "BECTON",
        "authorized_official_first_name": "NEISHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-520-0005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathways to Wellness, Medication Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.