COUTY OF MENDOCINO (NPI# 1770705139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770705139 |
Entity Type | Organization |
Organization Name | COUTY OF MENDOCINO |
Other Organization Name | ORR CREEK DAY TREATMENT PROGRAM |
Practice Address |
1011 Low Gap Road Ukiah CA 95482 |
Mailing Address |
1120 S Dora St Ukiah CA 95482-3919 |
Practice Telephone | 7074636878 |
Mailing Telephone | 7074722300 |
Enumeration Date | 2007-05-03 |
Last Update Date | 2014-02-03 |
Authorized Official Name | TOM PINIZOTTO (DIRECTOR) |
Authorized Official Telephone | 7074722300 |
Authorized Official Credential | MSW |
Is Organization Subpart | Y |
Parent Organization Name | COUTY OF MENDOCINO |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251S00000X | Community/Behavioral Health | Agencies | ||
N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
N | 302F00000X | Exclusive Provider Organization | Managed Care Organizations | ||
Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 2390 | 05 | |
CA | 00023 | 05 |
Other Name | Type Code |
---|---|
Orr Creek Day Treatment Program | Other Name - Individual/Organization |
Street Address |
1011 LOW GAP ROAD |
City | UKIAH |
State | CA |
Zip Code | 95482 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508296989 | Tapestry Family Services | Community/Behavioral Health | 1011 Low Gap Road, Ukiah, CA 95482 | 2013-11-20 |
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 | 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 |
---|---|---|---|---|
1922581537 | Solid Ground Counseling and Therapy Services Inc | Clinic/Center | 1120 W Church St, Ukiah, CA 95482-4603 | 2018-09-10 |
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.