Northstate Mental Wellness Clinic

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NORTHSTATE MENTAL WELLNESS CLINIC

Practice address

2920 Prospect Park Drive
Rancho Cordova, CA 95670

Phone

(916) 686-7300

NPI assigned

Jun 14, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Alvin Cheung, PHARMD

Title

President / Ceo

Phone

(916) 216-6202

Specialties & licenses 1

Addresses

Tax ID family

Northstate Mental Wellness Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Northstate Mental Wellness Clinic

  • Mental Health Counselor
  • Rancho Cordova, CA
  • NPI 1750137451
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Regina Isabel K'Burg, PSYD

  • Clinical Psychologist
  • Stockton, CA
  • NPI 1952647711
  NPD

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1093558363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 W TARON DRIVE",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95757",
            "telephone_number": "916-686-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 PROSPECT PARK DRIVE",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "95670",
            "telephone_number": "916-686-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTATE MENTAL WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "CHEUNG",
        "authorized_official_first_name": "ALVIN",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "916-216-6202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Nnoli
• David Noel, DDS, MPH
• Travis Ehren Noller
• North Valley Specialty Group Inc.
• Northern California Home Health Services
• Northstate Mental Wellness Clinic
• Emma Morgan Norvell, OTD, OTR/L
• Huda Nour
• Leslie O'Neill, LMFT
• Teresita Alviar Oandasan, CRNA

• Community/Behavioral Health Agency in Rancho Cordova, CA
• Providers in Rancho Cordova, 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 Jun 14, 2024; 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.