NPIMap

Organization Active NPI

Contra Costa Youth Service Bureau

  • Community/Behavioral Health Agency
  • Antioch, CA
National Provider Identifier
1619136132
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CONTRA COSTA YOUTH SERVICE BUREAU
Practice address
700 W 1St St
Antioch, CA 94509-1109
Phone
(925) 246-0300
Fax
(925) 246-0303
NPI assigned
Jun 9, 2008
Organization subpart
Yes
Parent organization
CONTRA COSTA YOUTH SERVICE BUREAUAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Mildred Naima Walls-Johnson, LMFT
Title
Clinical Manager of Operations
Phone
(510) 825-7994

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

700 W 1St St
Antioch, CA 94509-1109

Mailing address

186 Broadway
Richmond, CA 94804-1949
Phone (510) 215-4670

Other identifiers 1

IdentifierTypeStateIssuer
01919506MedicaidCA

Other names 1

  • West Contra Costa Youth Service Bureau Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Contra Costa Youth Service Bureau2 organizations share this tax ID, including this one
Part of
Contra Costa Youth Service Bureau

Other organizations with this tax ID 1

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

Locations

700 W 1st St
Antioch, CA 94509
Phone (925) 246-0300

3330 Clayton Rd
Ste C
Concord, CA 94519

3330 Clayton Rd
Ste D
Concord, CA 94519

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1619136132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 BROADWAY",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948041949",
            "telephone_number": "510-215-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W 1ST ST",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945091109",
            "telephone_number": "925-246-0300",
            "fax_number": "925-246-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTRA COSTA YOUTH SERVICE BUREAU",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONTRA COSTA YOUTH SERVICE BUREAU",
        "enumeration_date": "2008-06-09",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "WALLS-JOHNSON",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_middle_name": "NAIMA",
        "authorized_official_title_or_position": "CLINICAL MANAGER OF OPERATIONS",
        "authorized_official_telephone_number": "510-825-7994",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01919506",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Contra Costa Youth Service Bureau",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Apr 29, 2025; 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.