My Teen Mental Health LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MY TEEN MENTAL HEALTH LLC

Practice address

1101 Standiford Ave Ste A1
Modesto, CA 95350-0981

Phone

(201) 306-5670

NPI assigned

Jan 9, 2025

Organization subpart

No

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

Authorized official

Name

Sophie Gomes

Title

Authorized Official

Phone

(209) 457-5720

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1073323309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 RED HILL AVE STE A210C",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 STANDIFORD AVE STE A1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500981",
            "telephone_number": "201-306-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY TEEN MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "SOPHIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "209-457-5720"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mussa Banisadre MD Inc
• Besrat Mussa, LCSW
• Crystal Mustin
• Rayya Mutakabbir
• Brenda Mwesigwa, NP
• My Weigh Family Therapy Inc.
• Loretta Myers-Weber, NP-C
• Danielle Myers, MD
• Jerry Myers
• Laura Ann Myers, CADC-CAS

• Community/Behavioral Health Agency in Modesto, CA
• Providers in Modesto, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.