MOUNTAIN SIDE BEHAVIORAL HEALTH (NPI# 1972010650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972010650 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN SIDE BEHAVIORAL HEALTH |
| Other Organization Name | RESTORATION RECOVERY CENTER |
| Practice Address |
70 College Way Auburn CA 95603-5001 |
| Mailing Address |
506 S Spring St #13308 Smb 1389 Auburn CA 95603 |
| Practice Telephone | 9709484129 |
| Mailing Telephone | 9709484129 |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | AARON ESTRADA (COO/PROGRAM DIRECTOR) |
| Authorized Official Telephone | 9709484129 |
| Authorized Official Credential | CADC-II |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
51265 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | THIS IS THE MEDICAL DIRECTOR | 1063779163 | 01 |
| Other Name | Type Code |
|---|---|
| Restoration Recovery Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891319695 | Mountain Side Behavioral Health | Counselor | 1033 South Drive, Colfax, CA 95713 | 2020-06-08 |
| Street Address |
70 COLLEGE WAY |
| City | AUBURN |
| State | CA |
| Zip Code | 95603-5001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487271508 | James Robert Thornton | Social Worker | 398 Rhoes View Dr, Auburn, CA 95603 | 2020-07-06 |
| 1437713674 | June Meja Razzano | Psychoanalyst | 265 Nevada Station, Auburn, CA 95603 | 2019-04-23 |
| 1689175366 | Georgia Lee Bates | Speech-Language Pathologist | 2145 Bell Road, 215, Auburn, CA 95603 | 2018-02-27 |
| 1811406085 | Veronica Evette Magana | Specialist | 11485 C Ave, Auburn, CA 95603 | 2017-09-20 |
| 1043733777 | Ken Rescate | Physical Therapist | 2145 Bell Road, #215, Auburn, CA 95603 | 2017-07-25 |
| 1730534975 | Juanita Carey | Counselor | 1190 Heritage Oak Place, Auburn, CA 95603 | 2016-04-25 |
| 1255747010 | Cara Wilber | Marriage & Family Therapist | 11512 B Avenure, Auburn, CA 95603 | 2014-07-01 |
| 1538572094 | Mark Garrison | Pharmacist | 13386 Lincoln Way, Auburn, CA 95603 | 2014-06-03 |
| 1427460583 | Tessa Jacques | Marriage & Family Therapist | 263 Nevada Station, Auburn, CA 95603 | 2014-05-23 |
| 1629497359 | Elisabeth Ann Neubert-cook | Registered Nurse | 11484 B. Avenue, Auburn, CA 95603 | 2014-04-09 |
| Find all providers in zip 95603 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164044715 | James Raymond Watts | Counselor | 31624 117th Ave Se, Auburn, WA 98092-3697 | 2020-05-16 |
| 1992344329 | Jessica Megan Basaldua | Counselor | 178 Gamage Ave Apt 1, Auburn, ME 04210-4573 | 2020-01-02 |
| 1104397314 | Chanda Denise Allen | Counselor | 721 45th St Ne, Auburn, WA 98002-1303 | 2018-12-16 |
| 1447733746 | Theodore Parfet | Counselor | 12183 Locksley Ln # 101102, Auburn, CA 95602-2004 | 2018-09-12 |
| 1033612742 | Jeffery M Ostrom | Counselor | 12183 Locksley Ln Ste 201, Auburn, CA 95602-2052 | 2018-03-09 |
| 1962864421 | Yesenia Estrada | Counselor | 11837 Kemper Rd Ste 2, Auburn, CA 95603-9067 | 2016-03-24 |
| 1235507419 | Debra Rossi | Counselor | 12183 Locksley Ln Ste 103, Auburn, CA 95602-2050 | 2015-09-04 |
| 1023417136 | Canaan Sampson | Counselor | 11837 Kemper Rd, Auburn, CA 95603-9067 | 2014-08-14 |
| 1053754416 | Alex E Broady | Counselor | 17300 Se 392nd Street, Auburn, WA 98092 | 2013-04-16 |
| 1023350980 | Jaime S Tomlinson | Counselor | 50 Chicoine Ave, Auburn, ME 04210-8964 | 2013-03-19 |
| Find all providers in AUBURN | ||||
Please comment or provide details below to improve the information on MOUNTAIN SIDE BEHAVIORAL HEALTH.
| 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.