Provider Demographics
NPI:1144055302
Name:AH ADDICTION CARE OF CALIFORNIA PC
Entity type:Organization
Organization Name:AH ADDICTION CARE OF CALIFORNIA PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-385-1902
Mailing Address - Street 1:303 TWIN DOLPHIN DR STE 600-6002
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94065-1497
Mailing Address - Country:US
Mailing Address - Phone:844-542-5481
Mailing Address - Fax:877-237-0105
Practice Address - Street 1:500 CAPITOL MALL STE 2350
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-4737
Practice Address - Country:US
Practice Address - Phone:844-542-5481
Practice Address - Fax:877-237-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty