DEPARTMENT OF HEALTH SERVICES (NPI# 1376757989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376757989 |
| Entity Type | Organization |
| Organization Name | DEPARTMENT OF HEALTH SERVICES |
| Other Organization Name | DMH SONOMA COUNTY PACT |
| Practice Address |
7425 Rancho Los Guilicos Rd Santa Rosa CA 95409-6519 |
| Practice Telephone | 7075654700 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DIANA STORNETTA (COMPLIANCE AUDITOR ACCOUNTANT III) |
| Authorized Official Telephone | 7075654782 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| DMH Sonoma County PACT | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295167070 | Department of Health Services | Clinic/Center | 810 Grove St, Sonoma, CA 95476-5328 | 2013-08-05 |
| 1255547600 | Department of Health Services | Clinic/Center | 415 Humboldt St, Santa Rosa, CA 95404-4214 | 2007-05-15 |
| 1407068992 | Department of Health Services | Clinic/Center | 617 W 9th St, Santa Rosa, CA 95401-5438 | 2007-05-04 |
| 1639207103 | Department of Health Services | Clinic/Center | 3400 Chanate Rd, Santa Rosa, CA 95404-1710 | 2007-02-28 |
| 1205980547 | Department of Health Services | Clinic/Center | 415 Riley Street, Santa Rosa, CA 95404 | 2007-01-23 |
| 1841344181 | Department of Health Services | Substance Abuse Rehabilitation Facility | 1430 Neotomas Ave, Santa Rosa, CA 95405-7575 | 2007-01-23 |
| 1114071453 | Department of Health Services | Clinic/Center | 155 N. Pythian Road, Santa Rosa, CA 95409 | 2007-01-23 |
| 1376696914 | Department of Health Services | Clinic/Center | 2665a Dutton Mdw, Santa Rosa, CA 95407-7730 | 2007-01-18 |
| 1043668023 | Department of Health Services | Clinic/Center | 450 Bauchet St, Msb ----room E873, Los Angeles, CA 90012-2907 | 2016-05-31 |
| 1386076156 | Department of Health Services | Clinic/Center | 100 W 3rd St, Cloverdale, CA 95425-3204 | 2013-08-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DEPARTMENT OF HEALTH SERVICES | 50 Douglas Dr Ste 310a, Martinez, CA 94553-4003 |
| System for Award Management (SAM) Entities | DEPARTMENT OF HEALTH SERVICES/CLINICS | 4600 Broadway Ste 2500, Sacramento, CA 95820-1527 |
| Street Address |
7425 RANCHO LOS GUILICOS RD |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95409-6519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144697871 | Lisandro Villanueva | Counselor | 7425 Rancho Los Guilicos Rd, Dept. B, Santa Rosa, CA 95409-6519 | 2015-08-28 |
| 1427465277 | Bethany Balswick | Counselor | 7425 Rancho Los Guilicos Rd, Santa Rosa, CA 95409-6519 | 2014-07-14 |
| 1326386277 | Karen Jill Gnass | Registered Nurse | 7425 Rancho Los Guilicos Rd, Santa Rosa, CA 95409-6519 | 2013-01-28 |
| 1639413297 | Lemlem W Payne | Registered Nurse | 7425 Rancho Los Guilicos Rd, Santa Rosa, CA 95409-6519 | 2012-11-20 |
| 1568710556 | Amber Marie Bruno | Marriage & Family Therapist | 7425 Rancho Los Guilicos Rd, Santa Rosa, CA 95409-6595 | 2012-08-22 |
| 1588932107 | Carla Rae Obrien-jay | Registered Nurse | 7425 Rancho Los Guilicos Rd, Santa Rosa, CA 95409-6519 | 2011-12-09 |
| 1518283316 | Richard Graham White IIi | Counselor | 7425 Rancho Los Guilicos Rd, Dept B, Santa Rosa, CA 95409-6519 | 2010-04-19 |
| 1992961767 | Kellye Susan Brassel | Registered Nurse | 7425 Rancho Los Guilicos Rd, Santa Rosa, CA 95409-6519 | 2008-07-31 |
| 1609063098 | Diana E Antonio | Registered Nurse | 7425 Rancho Los Guilicos Rd, Dept A, Santa Rosa, CA 95409-6519 | 2007-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568005205 | Angela Tejeda | Counselor | 35555 Sonoma Hwy, Santa Rosa, CA 95409 | 2019-10-25 |
| 1609335314 | Heidi Diebel | Marriage & Family Therapist | 9291 Oak Trail Cir, Santa Rosa, CA 95409 | 2019-03-13 |
| 1427525328 | Christopher William Schouest | Behavioral Analyst | 5424 Sharon St., Santa Rosa, CA 95409 | 2018-10-29 |
| 1194178756 | Ana Ceniceros | Registered Nurse | 7425 Los Guilucos Rd, Santa Rosa, CA 95409 | 2016-07-19 |
| 1669842878 | Kimberly Harris | Counselor | 7425 Los Guilicos Rd., Dept. H, Santa Rosa, CA 95409 | 2015-09-30 |
| 1568884849 | Christopher Cincotta | Counselor | 540 Middle Rincon Road, Santa Rosa, CA 95409 | 2014-01-06 |
| 1104186626 | Gina Ruth Sarpy | Marriage & Family Therapist | 7425 Los Guilicos Rd, Dept. H, Santa Rosa, CA 95409 | 2012-05-17 |
| 1467745950 | Courtney King | Family Medicine | 4702 Starbuck Ave, Santa Rosa, CA 95409 | 2011-05-17 |
| 1427351162 | Robert E Richardson Md Professional Corp. | Surgery | 1812 Happy Valley Road, Santa Rosa, CA 95409 | 2010-12-20 |
| 1497063564 | Edmundo Simon Martinez IIi IIi | Occupational Therapist | 5555 Montgomery Dr., Santa Rosa, CA 95409 | 2010-09-22 |
| Find all providers in zip 95409 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790822955 | Individuals Now, Inc | Clinic/Center | 2447 Summerfield Road, Santa Rosa, CA 95405 | 2007-01-30 |
| 1457498636 | County of Sonoma | Clinic/Center | 2227 Capricorn Way Ste 207, Santa Rosa, CA 95407-5486 | 2007-01-30 |
| 1629124037 | County of Sonoma | Clinic/Center | 2235 Challenger Way Ste 107-108, Santa Rosa, CA 95407-5458 | 2007-01-26 |
| 1245604909 | Sonoma County Counseling | Clinic/Center | 3434 Mendocino Ave, Building C, Santa Rosa, CA 95403-2274 | 2015-11-18 |
| 1841409224 | Department of Health Services | Clinic/Center | 3322 Chanate Rd, Santa Rosa, CA 95404-1708 | 2007-05-22 |
| 1336286244 | Department of Health Services | Clinic/Center | 3322 Chanate Rd, #49269n, Santa Rosa, CA 95404-1708 | 2007-01-31 |
| 1245377159 | Department of Health Services | Clinic/Center | 3322 Chanate Rd, #49269s, Santa Rosa, CA 95404-1708 | 2007-01-31 |
| 1538206446 | Department of Health Services | Clinic/Center | 3333 Chanate Rd, #49269r, Santa Rosa, CA 95404-1707 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073112157 | 10-20 Club Inc. | Clinic/Center | 8221 3rd St Ste 403, Downey, CA 90241-3733 | 2020-10-20 |
| 1447857040 | Mary Cox, Lmft | Clinic/Center | 13800 Heacock St Ste 230a, Moreno Valley, CA 92553-8824 | 2020-10-06 |
| 1821607771 | Tonya Octave, Lcsw, Prof Corp | Clinic/Center | 237 S Lakeview Ave Ste A, Placentia, CA 92870-6756 | 2020-07-27 |
| 1972121762 | Environmental Alternatives Susanville | Clinic/Center | 2003 Main St, Susanville, CA 96130-4501 | 2020-07-08 |
| 1083231781 | Treehouse Child Therapy Professional Corporation | Clinic/Center | 514 N California Ave Ste 13, Beaumont, CA 92223-2120 | 2020-06-29 |
| 1083230262 | Socal Adolescent Wellness, Inc. | Clinic/Center | 23072 Lake Center Dr Ste 214, Lake Forest, CA 92630-2899 | 2020-06-23 |
| 1447876123 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 454 E Cerritos St, Rialto, CA 92376-3658 | 2020-06-18 |
| 1669098505 | Rowi Valencia, Inc. | Clinic/Center | 27413 Tourney Rd Ste 150, Valencia, CA 91355-5604 | 2020-06-16 |
| 1386267870 | Bni Treatment Centers | Clinic/Center | 2563 Stokes Canyon Rd, Calabasas, CA 91302-2991 | 2020-05-19 |
| 1538781042 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 3872 Carthage St, Riverside, CA 92501-2102 | 2020-05-07 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95409 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.