NPIMap

Organization Active NPI

Department of Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Rosa, CA
National Provider Identifier
1255547600
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
DEPARTMENT OF HEALTH SERVICES
Practice address
415 Humboldt St
Santa Rosa, CA 95404-4214
Phone
(707) 565-4850
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Diana Stornetta
Title
Compliance Auditor Accountant III
Phone
(707) 565-4782

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

415 Humboldt St
Santa Rosa, CA 95404-4214

Mailing address

415 Humboldt St
Santa Rosa, CA 95404-4214

Other identifiers 1

IdentifierTypeStateIssuer
49ANOtherCAPROVIDER NUMBER

Other names 1

  • DMH Integrated Services for Homeless Adults Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Hospital of61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

415 Humboldt St
Santa Rosa, CA 95404
Phone (707) 657-9464

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255547600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 HUMBOLDT ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 HUMBOLDT ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044214",
            "telephone_number": "707-565-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STORNETTA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "COMPLIANCE AUDITOR ACCOUNTANT III",
        "authorized_official_telephone_number": "707-565-4782"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "49AN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMH Integrated Services for Homeless Adults",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.