COUNTY OF MENDOCINO (NPI# 1437296282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437296282 |
| Entity Type | Organization |
| Organization Name | COUNTY OF MENDOCINO |
| Other Organization Name | SUBSTANCE USE DISORDERS TREATMENT |
| Practice Address |
1120 S Dora St Ukiah CA 95482-6340 |
| Practice Telephone | 7074722637 |
| Practice Fax Number | 7074722657 |
| Mailing Telephone | 7074722637 |
| Mailing Fax Number | 7074722657 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2014-07-01 |
| Authorized Official Name | JENINE MILLER (BHRS DEPUTY DIRECTOR) |
| Authorized Official Telephone | 7074722637 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251K00000X | Public Health or Welfare | Agencies | ||
| N | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
Ambulatory Health Care Facilities | ||
| N | 261QP0905X |
Clinic/Center Specialization: Public Health, State or Local |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | UKIAH DRUG MEDICAL # | 2305 | 01 |
| Other Name | Type Code |
|---|---|
| Substance Use Disorders Treatment | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366868671 | County of Mendocino | Community/Behavioral Health | 474 E. Valley Street, Willits, CA 95490-3635 | 2014-03-11 |
| 1407080898 | County of Mendocino | Clinic/Center | 405 Observatory Ave, Ukiah, CA 95482-5641 | 2009-05-13 |
| 1710016829 | County of Mendocino | Case Management | 518 Low Gap Rd, Ukiah, CA 95482-3735 | 2007-03-05 |
| 1063558823 | County of Mendocino | Public Health or Welfare | 221 S Lenore Ave, Willits, CA 95490-3632 | 2007-01-29 |
| 1528104387 | County of Mendocino | Public Health or Welfare | 790 S Franklin St, Fort Bragg, CA 95437-5456 | 2007-01-29 |
| 1588730642 | County of Mendocino | Clinic/Center | 860 N Bush St, Ukiah, CA 95482-3919 | 2006-11-28 |
| 1265858575 | County of Mendocino | Community/Behavioral Health | 727 S. State Street, Ukiah, CA 95482-5815 | 2014-03-11 |
| 1477985091 | County of Mendocino | Community/Behavioral Health | 727 S State St, Ukiah, CA 95482-5815 | 2013-08-06 |
| 1831478148 | County of Mendocino | Clinic/Center | 790 S Franklin St, Suite #b, Fort Bragg, CA 95437-5456 | 2011-08-04 |
| 1780818179 | County of Mendocino | Clinic/Center | 2240 Old River Rd, Ukiah, CA 95482-6103 | 2009-05-13 |
| Street Address |
1120 S DORA ST |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-6340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811005440 | Carol Lynne Kelsey | Nurse Practitioner | 1120 S Dora St, Ukiah, CA 95482-6340 | 2006-08-25 |
| 1306471230 | Luz Maria Machado Cramer | Counselor | 1120 S Dora St, Ukiah, CA 95482-6340 | 2020-03-11 |
| 1265073977 | Melinda Joann-holt Driggers | Case Manager/Care Coordinator | 1120 S Dora St, Ukiah, CA 95482-6340 | 2019-10-03 |
| 1437708450 | Paul Murguia IIi | Counselor | 1120 S Dora St, Ukiah, CA 95482-6340 | 2019-09-11 |
| 1548822851 | Jessica Toste | Licensed Vocational Nurse | 1120 S Dora St, Ukiah, CA 95482-6340 | 2019-07-08 |
| 1063985398 | Mimi Whittaker | Case Manager/Care Coordinator | 1120 S Dora St, Ukiah, CA 95482-6340 | 2019-01-09 |
| 1801368527 | Khadananda Bhandari | Case Manager/Care Coordinator | 1120 S Dora St, Ukiah, CA 95482-6340 | 2018-12-19 |
| 1053899203 | Chiah Jasmine Cassells | Counselor | 1120 S Dora St, Ukiah, CA 95482-6340 | 2018-07-31 |
| 1285110437 | Natalie Levchenko | Registered Nurse | 1120 S Dora St, Ukiah, CA 95482-6340 | 2018-07-11 |
| 1093206153 | Sharon Convery | Registered Nurse | 1120 S Dora St, Ukiah, CA 95482-6340 | 2018-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
| 1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
| 1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
| 1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
| 1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
| 1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
| Find all providers in zip 95482 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1558702795 | Redwood Community Services, Inc | Community/Behavioral Health | 800 N. State Street, (rcs - Mffa / Tfc), Ukiah, CA 95482 | 2013-07-16 |
| 1972776904 | Tapestry Family Services, Inc. | Community/Behavioral Health | 201a E Gobbi St, Ukiah, CA 95482-5513 | 2008-04-10 |
| 1770705139 | Couty of Mendocino | Community/Behavioral Health | 1011 Low Gap Road, Ukiah, CA 95482 | 2007-05-03 |
| 1932242310 | Tapestry Family Services | Community/Behavioral Health | 3800 Low Gap Rd, Ukiah, CA 95482-3740 | 2007-02-15 |
| 1932241833 | Tapestry Family Services | Community/Behavioral Health | 169 Mason St Ste 300, Ukiah, CA 95482-4483 | 2007-02-14 |
| 1265858575 | County of Mendocino | Community/Behavioral Health | 727 S. State Street, Ukiah, CA 95482-5815 | 2014-03-11 |
| 1508296989 | Tapestry Family Services | Community/Behavioral Health | 1011 Low Gap Road, Ukiah, CA 95482 | 2013-11-20 |
| 1831523091 | Manzanita Services Inc. | Community/Behavioral Health | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2013-08-23 |
| 1477985091 | County of Mendocino | Community/Behavioral Health | 727 S State St, Ukiah, CA 95482-5815 | 2013-08-06 |
| Find all providers in UKIAH | ||||
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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.