NPIMap

Organization Active NPI

Cordilleras Mental Health Corporation

Doing business as Cordilleras Mental Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Redwood City, CA
National Provider Identifier
1063509123
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
DMH 02 68 015 Issued in CA
Legal business name
CORDILLERAS MENTAL HEALTH CORPORATION
Doing business as
Cordilleras Mental Health Services
Practice address
200 Edmonds Rd
Redwood City, CA 94062-3813
Phone
(650) 367-1890
Fax
(650) 369-6465
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lorena Lopez
Title
Provider Relations Supervisor
Phone
(510) 337-7950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X DMH 02 68 015 CA Primary

Addresses

Primary practice location

200 Edmonds Rd
Redwood City, CA 94062-3813

Mailing address

1080 Marina Village Parkway
Suite 100
Alameda, CA 94501-1078
Phone (510) 337-7950

Other identifiers 1

IdentifierTypeStateIssuer
ZZR18511GOtherCAMEDICAID

Other names 1

  • Cordilleras Mental Health Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cordilleras Mental Health Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1063509123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PARKWAY",
            "address_2": "SUITE 100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011078",
            "telephone_number": "510-337-7950",
            "fax_number": "510-337-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EDMONDS RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940623813",
            "telephone_number": "650-367-1890",
            "fax_number": "650-369-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDILLERAS MENTAL HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "LORENA",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SUPERVISOR",
        "authorized_official_telephone_number": "510-337-7950"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": "DMH 02 68 015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "ZZR18511G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordilleras Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cordilleras Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.