MENDOCINO COUNTY


Address: 474 East Valley Street, Willits, CA 95490
Phone: 7074722300

MENDOCINO COUNTY (NPI# 1629107735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
CA 00023 05
CA 2367 05
CA MH SUBMITTER # BBB33295B 01

Other Provider/Organization Names

Other Name Type Code
Mental Health Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1275941676 Mendocino County Public Health or Welfare 1120 S Dora St, Ukiah, CA 95482-6340 2014-07-29

Other Data Sources

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

Office Location

Street Address 474 EAST VALLEY STREET
City WILLITS
State CA
Zip Code 95490

Providers in the same zip code

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 Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children Mental Health

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902459878 Tapestry Family Services, Inc. Clinic/Center 733 S Main St, Willits, CA 95490-3913 2019-07-19

Providers in the same taxonomy and state

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

Competitor

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City WILLITS
Zip Code 95490

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Dataset Information

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.

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