MENDOCINO COUNTY (NPI# 1629107735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629107735 |
Entity Type | Organization |
Organization Name | MENDOCINO COUNTY |
Other Organization Name | MENTAL HEALTH |
Practice Address |
474 East Valley Street Willits CA 95490 |
Mailing Address |
1120 S Dora St Ukiah CA 95482-6340 |
Practice Telephone | 7074722300 |
Practice Fax Number | 7074722331 |
Mailing Telephone | 7074722300 |
Mailing Fax Number | 7074722331 |
Enumeration Date | 2007-03-05 |
Last Update Date | 2016-01-22 |
Authorized Official Name | JENINE MILLER (BHRS DEPUTY DIRECTOR) |
Authorized Official Telephone | 7074722300 |
Authorized Official Credential | PSY.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
N | 302F00000X | Exclusive Provider Organization | Managed Care Organizations | ||
N | 251B00000X | Case Management | Agencies | ||
N | 251S00000X | Community/Behavioral Health | Agencies | ||
Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 00023 | 05 | |
CA | 2367 | 05 | |
CA | MH SUBMITTER # | BBB33295B | 01 |
Other Name | Type Code |
---|---|
Mental Health | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275941676 | Mendocino County | Public Health or Welfare | 1120 S Dora St, Ukiah, CA 95482-6340 | 2014-07-29 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MENDOCINO COUNTY DISTRICT ATTORNEY | 100 N State St Rm 10, Ukiah, CA 95482-4416 |
System for Award Management (SAM) Entities | MENDOCINO COUNTY HEALTH AND HUMAN SERVICES AGENCY | 737 South State Street, Ukiah, CA 95482-5815 |
System for Award Management (SAM) Entities | MENDOCINO COUNTY LIBRARY | 105 N Main St, Ukiah, CA 95482-4403 |
System for Award Management (SAM) Entities | MENDOCINO COUNTY OFFICE OF EDUCATION | 2240 Old River Rd, Ukiah, CA 95482-6103 |
System for Award Management (SAM) Entities | MENDOCINO COUNTY RESOURCE CONSERVATION DISTRICT | 410 Jones St Ste C3, Ukiah, CA 95482-5491 |
System for Award Management (SAM) Entities | MENDOCINO COUNTY YOUTH PROJECT | 776 S State St Ste 107, Ukiah, CA 95482-5858 |
Street Address |
474 EAST VALLEY STREET |
City | WILLITS |
State | CA |
Zip Code | 95490 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679194971 | Laisenia Sau | Specialist | 180 E Barbara Lane, Willits, CA 95490 | 2020-04-28 |
1588160527 | Redwood Quality Management Company, Inc. | Community/Behavioral Health | 99 S. Humoldt Street #2, Willits, CA 95490 | 2018-03-30 |
1497063861 | Daniel Doyle | Audiologist | 474 E. Valley St., Willits, CA 95490 | 2010-09-20 |
1659524346 | Erika Littlefawn Tsonetokoy Coyle | Counselor | 110 E Mendocino Ave, Willits, CA 95490 | 2008-10-28 |
1912180548 | Paul F Jacobson | Marriage & Family Therapist | 221-b S. Lenore Avenue, Willits, CA 95490 | 2007-12-05 |
1821136482 | Jeff A Cramer | Marriage & Family Therapist | 99 East Humboldt Street, Willits, CA 95490 | 2007-02-02 |
1215098215 | Esther Judith Faber | Marriage & Family Therapist | 104 W Mendocino Ave, Willits, CA 95490 | 2006-12-13 |
1174684492 | Diana E Levy-peart | Chiropractor | 1225 South Main Street, Willits, CA 95490 | 2006-12-12 |
1396810628 | Maria Theresa Bates | Social Worker | Maria T Bates Lcsw, 660 So Main St Suite D, Willits, CA 95490 | 2006-11-21 |
1184727620 | Alfred F Kerr | Dentist | 12 W Valley St, Willits, CA 95490 | 2006-09-07 |
Find all providers in zip 95490 |
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 |
---|---|---|---|---|
1902459878 | Tapestry Family Services, Inc. | Clinic/Center | 733 S Main St, Willits, CA 95490-3913 | 2019-07-19 |
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 |
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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.