NPIMap

Organization Active NPI

County of Humboldt

Doing business as Humboldt County Behavioral Health - Sempervirens

  • Psychiatric Hospital Unit
  • Eureka, CA
National Provider Identifier
1194763219
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
1 01 6003 Issued in CA
Legal business name
COUNTY OF HUMBOLDT
Doing business as
Humboldt County Behavioral Health - Sempervirens
Practice address
720 Wood St
Eureka, CA 95501-4413
Phone
(707) 268-2900
NPI assigned
Jun 2, 2006
Last updated
Sep 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Authorized official

Name
Emi Botzler-Rodgers, LMFT
Title
Behavioral Health Director
Phone
(707) 268-2990

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 1 01 6003 CA Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

720 Wood St
Eureka, CA 95501-4413

Mailing address

720 Wood St
Eureka, CA 95501-4413
Phone (707) 268-2900

Other identifiers 1

IdentifierTypeStateIssuer
000001229MedicaidCA

Other names 1

  • Humboldt County Behavioral Health - Sempervirens Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090212000380 CA Part A Provider - Hospital 4082516950 Practice locations: Eureka, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194763219. Details of each certification follow.

Hospital certification: CCN 054124

Legal name
COUNTY OF HUMBOLDT
Doing business as
HUMBOLDT COUNTY MENTAL HEALTH - SEMPERVIRENS
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Feb 5, 1992
Last certification
Sep 21, 2023
Beds
16
Ownership / control type
Local
Organization structure
GovernmentNon-profit
Enrollment address
720 Wood Street
Eureka, CA 95501-4413
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
SempervirensCCN 054124 · All quality measures
Type
Psychiatric
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Humboldt County Mental35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
County of Humboldt Organization, Eureka, CA 5% Or Greater Direct Ownership Interest Jan 31, 1988 100%
Emilisa Botzler-Rodgers Individual W-2 Managing EmployeeBehavioral Health Director Aug 13, 2017 100%
Connie L Beck Individual Corporate OfficerDirector, DHHS May 5, 2013

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1194763219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WOOD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014413",
            "telephone_number": "707-268-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WOOD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014413",
            "telephone_number": "707-268-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF HUMBOLDT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "BOTZLER-RODGERS",
        "authorized_official_first_name": "EMI",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "707-268-2990",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "CA",
            "license": "1 01 6003",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000001229",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humboldt County Behavioral Health - Sempervirens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.